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Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus: 2009 Update by the HIV Medicine Association of the Infectious Diseases Society of America

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HIV is sexually transmitted disease caused by the retrovirus seen in 95% of individuals living in developing countries. Management of the disease is the mainstay. Evidence based guidelines was carried out by the health care experts for the screening, diagnosis, treatment and adherence of the disease. Group of specialists prepared the guidelines after reviewing and analyzing the older literatures. Infectious Diseases Society of America viewed the systematic quality and evidence based study. The following guidelines were formed for the management of persons infected or at risk of being infected with the HIV.

HIV type 1 (HIV-1) should be diagnosed with rapid HIV diagnoses or conventional enzyme-linked immunoabsorbents assay (ELISA) and confirmed by Western blot or indirect immunofluorescence assay (A-I).

Screening is to be carried out for high-risk behavior (A-II) patients who are at a risk of transmitting HIV infection to the surrounding environment. Patients should also be asked about the symptom at every visit.

Educational materials (posters, patient information leaflets, videos) are to be circulated to the health care setting to reduce the risk related to behaviors. Counseling should be provided to high-risk behavioral patients.

Before initiation of medical care, all past medical history, physical examination and HIV-related information should be obtained from all patients. Tropism testing should be performed prior to initiation of antiviral drug. Blood count and chemistry panel should be obtained before the initiation of care. Qualitative screening for Glucose 6 Phosphate Dehydrogenase should be carried out.

Fasting lipid levels are elevated due to the antiretroviral treatment, HIV infection itself, and host factors. Thus lipid profile tests are carried out. Baseline urinalysis and calculated creatinine clearance assay is to be considered, especially in black HIV‐infected patients and also in those with advanced disease or comorbid conditions due to increased risk of nephropathy. Mantoux method or interferon- γ release assay should be tested for tuberculosis infection .Viral hepatitis, herpes viruses; syphilis should be screened and vaccinated before the initial care.

Plans and desires should be expressed before initiating care in pregnancy of HIV-infected women. Mammography should be performed in women aged >50 years to determine the breast cancer.

Antiviral therapy and prognosis have been improving from the past contributing to achieve increased survival and restricting the severe complication. High risks are to be considered in treating pregnant and infants.

Source: http://www.journals.uchicago.edu/doi/full/10.1086/605292

Written by: healthplus24.com team

Date last updated: December 08, 2014

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