Care of Patients With HIV Infection: Diagnosis and Monitoring.
Appropriate screening for HIV infection is the cornerstone of HIV-related care. There have been several recent changes in testing technology and screening recommendations. The US Preventive Services Task Force recommends universal HIV screening at least once for adolescents and adults ages 15 to 65 years, and additional screening for patients at higher risk, although evidence is insufficient to determine optimum rescreening intervals. All pregnant women should be screened for HIV infection in the first trimester, and pregnant women at high risk should be screened again in the third trimester. The Centers for Disease Control and Prevention recommends use of an algorithm using fourth-generation tests for screening; this decreases the window period between infection and detection to as few as 14 days, thereby reducing the number of false-negative results. Home HIV testing kits, which require follow-up confirmatory testing, also are available. Clinicians should be aware of HIV-specific laws in their states, including those criminalizing HIV exposure and transmission. Thorough medical and laboratory evaluations are essential at initiation of care for patients with HIV infection, along with appropriate follow-up monitoring, as recommended in various guidelines.
Family Health Center of Worcester, 26 Queen St., Worcester, MA 01610.
Philip
P
Bolduc
Family Health Center of Worcester, 26 Queen St., Worcester, MA 01610.
Navid
N
Roder
Family Health Center of Worcester, 26 Queen St., Worcester, MA 01610.
Emily
E
Colgate
University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655.
Sarah H
SH
Cheeseman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D018791:CD4 Lymphocyte Count; D003416:Criminal Law; D005260:Female; D015483:HIV Antibodies / Q000276:immunology; D016655:HIV Core Protein p24 / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology; D015498:HIV-2 / Q000276:immunology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012367:RNA, Viral / Q000097:blood*; D011933:Reagent Kits, Diagnostic; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States; D019562:Viral Load; D055815:Young Adult
D015483:HIV Antibodies; D016655:HIV Core Protein p24; D012367:RNA, Viral; D011933:Reagent Kits, Diagnostic