Updated guidelines released for management of HIV in primary care

The HIV Medicine Association of the Infectious Diseases Society of America (IDSA) released updated guidelines last week on management of HIV in primary care.

The evidence-based guidelines, which replace those issued in 2009, were developed by an expert panel and are intended for clinicians who care for patients infected with HIV. Because people with HIV are living longer, the guidelines include information on optimal preventive care, such as screening for diabetes, osteoporosis, colon cancer and other disorders. Patients whose HIV infection is controlled should now have viral levels monitored every 6 to 12 months rather than every 3 to 4 months, the new guidelines state. The guidelines also recommend that patients with HIV infection be vaccinated against pneumococcal infection, influenza, varicella and hepatitis A and B.

The guidelines include an expanded section on sexually transmitted diseases and a new section on metabolic abnormalities, the latter replacing separate, previously published guidelines on dyslipidemia. The guidelines feature tables on routine immunizations and routine health care maintenance in HIV-infected adults, as well as several tables outlining recommendations for the initial assessment of an HIV-infected patient (history, review of systems and physical exam, and initial laboratory and other tests) and a table detailing potential reactions between antiretroviral drugs and statins.

The full text of the guidelines, which were published early Nov. 14 by Clinical Infectious Diseases, is available online.