Version May 2024
| Test | Interval |
| HIV-related testing | |
| HIV serology | At baseline if there is no laboratory documentation of infection |
| CD4 cell count | At baseline Every 3 to 6 months (may be extended to ≥12 months in clinically stable patients on ART*) |
| HIV viral load | At baseline After ART initiation:
|
| Genotypic resistance testing | At baseline Prior to initiation of ART, if delayed (recommended in pregnant women; optional for others if performed at baseline visit) |
| HLA-B5701 testing | If considering use of abacavir |
| Tropism testing | If considering use of maraviroc |
| Assessing cardiovascular risk | |
| Blood pressure check | At baseline and annually (or more frequently as indicated) |
| Random or fasting glucose and/or hemoglobin A1c | At baseline 1 to 3 months following ART initiation or modification and then annually¶ |
| Fasting lipid profile | At baseline and annuallyΔ |
| Weight assessment | At baseline and follow-up visits |
| Tobacco use assessment | At baseline and annually |
| Aortic aneurysm screening (abdominal ultrasonography) | Once in men 65 to 75 years old who have ever smoked |
| Assessing other risks | |
| Bone densitometry | At baseline in postmenopausal women and men ≥50 years old Subsequent testing frequency depends on findings on baseline exam |
| Screening for neuropsychiatric disorders | |
| Depression screening | At baseline and annually |
| Screening for cognitive deficits | At baseline and annually |
| Screening for cancer | |
| Colonoscopy | At 45 years old in asymptomatic patients at average risk Earlier screening may be warranted for those with strong family history of colon cancer Subsequent testing frequency depends on findings on baseline exam |
| Mammography | Every other year or annually in women 50 to 74 years old◊ |
| Cervical Pap smear (with or without HPV testing in women ≥30 years) | At baseline; interval for repeat testing depends on results and whether HPV co-testing was performed§ Additional testing may be warranted for those with abnormal results |
| Anal Pap smear | Consider at baseline and annually More frequent or additional testing may be warranted for those with abnormal results |
| Prostate-specific antigen | For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)-based screening for prostate cancer should be individualized¥ |
| Low-dose helical chest CT | Adults age 50 to 80 years old who are at risk of lung cancer due to smoking (at least a 20 pack-year smoking history and are either current smokers or former smokers having quit within the past 15 years) |
| Screening for infections | |
| Syphilis serology | At baseline Annually for sexually active persons (or more frequently if at high risk) |
| Chlamydia and gonorrhea testing (at all sites of potential exposure) | At baseline Annually for sexually active persons (or more frequently if at high risk) |
| Trichomonas | At baseline for all women Annually for sexually active women |
| TB testing (TST or IGRA) | At baseline unless there is a history of a prior positive test Annually in patients at ongoing risk for TB unless there is a history of a prior positive test |
| HAV and HBV serologies | At baseline, with vaccination(s) in persons not immune |
| HCV serology, with reflex viral level for positive result | At baseline Annually in patients at risk (eg, persons who inject drugs, men who have sex with men, transgender women) |
| Dilated fundoscopic exam | Consider every 12 months in patients with CD4 cell count <50 cells/microL |
| Monitoring for medication toxicity | |
| Complete blood count with differential | At baseline Complete blood count with differential every 3 to 6 months when monitoring CD4 count and every year once the CD4 count is no longer monitored |
| BUN and creatinine‡† | At baseline 4 to 8 weeks after ART initiation and every 6 months thereafter |
| ALT, AST, and total bilirubin | At baseline 4 to 8 weeks after ART initiation and every 6 months thereafter |
| Urinalysis | At baseline After ART initiation or change Every 12 months on ART (every 6 months while on tenofovir disoproxil fumarate or tenofovir alafenamide-containing regimens) |
ALT: alanine aminotransferase; ART: antiretroviral therapy; AST: aspartate aminotransferase; BUN: blood urea nitrogen; HAV: hepatitis A virus; HBV: hepatitis B virus; HCV: hepatitis C virus; HIV: human immunodeficiency virus; HLA: human leukocyte antigen; HPV: human papillomavirus; IGRA: interferon-gamma release assay; TB: tuberculosis; TST: tuberculin skin test.
* Less frequent CD4 count monitoring is appropriate in patients who have a stable CD4 cell count at a level well above the threshold for opportunistic infection risk (eg, >300 cells/microL) and have a consistently undetectable viral load. Refer to the topic that discusses patient monitoring during HIV ART for more detailed recommendations.
¶ Glycated hemoglobin should not be routinely used to diagnose diabetes mellitus in patients on ART, as HbA1c may underestimate glycemia, especially in those with a low CD4 cell count.
Δ Some experts also check lipids 1 to 3 months following ART initiation or modification.
◊ Refer to UpToDate content on breast cancer screening for more detailed information, including recommendations for other age groups.
§ Refer to the UpToDate topic on HIV and women for additional details.
¥ Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision. Refer to UpToDate content on prostate cancer screening to guide these discussions.
‡ Determination of renal function should include estimation of CrCl or glomerular filtration rate. More frequent monitoring may be indicated for patients with evidence of kidney disease (eg, proteinuria, decreased glomerular dysfunction) or increased risk of renal insufficiency (eg, patients with diabetes, hypertension).
† Some experts also suggest monitoring the phosphorus levels of patients on tenofovir disoproxil fumarate.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
