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Keywords:

  • antiretroviral-experienced;
  • antiretroviral-naïve;
  • assessment;
  • HIV positive;
  • monitoring

Table of Contents

1. Levels of evidence
1.1 Reference
2. Introduction
3. Auditable targets
4. Table summaries
4.1 Initial diagnosis
4.2 Assessment of ART-naïve individuals
4.3 ART initiation
4.4 Initial assessment following commencement of ART
4.5 Routine monitoring on ART
4.6 References
5. Newly diagnosed and transferring HIV-positive individuals
5.1 Initial HIV-1 diagnosis
5.2 Tests to determine whether acquisition of HIV infection is recent
5.3 Individuals transferring care from a different HIV healthcare setting
5.4 Communication with general practitioners and shared care
5.5 Recommendations
5.6 References
6. Patient history
6.1 Initial HIV-1 diagnosis
6.2 Monitoring of ART-naïve patients
6.3 Pre-ART initiation assessment
6.4 Monitoring individuals established on ART
6.5 Assessment of adherence
6.6 Recommendations
6.7 References
7. Examination
7.1 Recommendations
8. Identifying the need for psychological support
8.1 References
9. Assessment of immune status
9.1 CD4 T cell counts
9.2 CD4 T cell percentage
9.3 References
10. HIV viral load
10.1 Initial diagnosis/ART naïve
10.2 Post ART initiation
10.3 Individuals established on ART
10.4 Recommendations
10.5 References
11. Technical aspects of viral load testing
11.1 References
12. Viral load kinetics during ART and viral load ‘blips’
12.1 References
13. Proviral DNA load
13.1 References
14. Resistance testing
14.1 Initial HIV-1 diagnosis
14.2 ART-naïve
14.3 Post treatment initiation
14.4 ART-experienced
14.5 References
15. Subtype determination
15.1 Disease progression
15.2 Transmission
15.3 Performance of molecular diagnostic assays
15.4 Response to therapy
15.5 Development of drug resistance
15.6 References
16. Other tests to guide use of specific antiretroviral agents
16.1 Tropism testing
16.2 HLA B*5701 testing
16.3 References
17. Therapeutic drug monitoring
17.1 Recommendations
17.2 References
18. Biochemistry testing
18.1 Introduction
18.2 Liver function
18.3 Renal function
18.4 Dyslipidaemia in HIV-infected individuals
18.5 Other biomarkers
18.6 Bone disease in HIV-infected patients
18.7 References
19. Haematology
19.1 Haematological assessment and monitoring
19.2 Recommendations
19.3 References
20. Serology
20.1 Overview
20.2 Hepatitis viruses
20.3 Herpes viruses
20.4 Measles and rubella
20.5 Cytomegalovirus (CMV)
20.6 References
21. Other microbiological screening
21.1 Tuberculosis screening
21.2 Toxoplasma serology
21.3 Tropical screening
21.4 References
22. Sexual health screening including anal and cervical cytology
22.1 Sexual history taking, counselling and sexually transmitted infection (STI) screening
22.2 Cervical and anal cytology
22.3 Recommendations
22.4 References
23. Routine monitoring recommended for specific patient groups
23.1 Women
23.2 Older age
23.3 Injecting drug users
23.4 Individuals coinfected with HBV and HCV
23.5 Late presenters
23.6 References
Appendix