A Guide to Primary Care of People with HIV/AIDS - Canadian Public ...

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A Guide to Primary Care of People with HIV/AIDS Chapter 3: Core Elements of HIV Primary Care 3 ONGOING CARE After the initial evaluation is completed, how often do patients need to be seen? In general, patients with early-stage disease are seen at 3-month intervals to undergo routine medical evaluation and monitoring of CD4 cell count, viral load, and CBC. During the initial evaluation more frequent visits are common because there is so much information to transmit. Visits should also be more frequent when therapy is introduced and when the CD4 cell count is 200/mm 3 , whose complaints are rarely due to HIV or its complications, 2) patients with a CD4 cell count of
A Guide to Primary Care of People with HIV/AIDS Chapter 3: Core Elements of HIV Primary Care KEY POINTS The focus of the first visit is determined by the patient’s most immediate needs. The initial evaluation is complex and usually requires several visits. An important aspect of primary care is answering the patient’s questions to ensure that he or she understands the HIV disease process and treatment. While patients with early-stage HIV disease can be seen at 3-month intervals for routine medical evaluation, those receiving ART or with more advanced disease must be seen more frequently. A multidisciplinary team approach with the patient as primary caregiver is the best approach to care. SUGGESTED RESOURCES Bartlett JG, Gallant J. Medical Management of HIV Infection. Baltimore, MD: Johns Hopkins University; 2003. Buckley RM, Gluckman SJ. HIV Infection in Primary Care. Philadelphia, PA: WB Saunders, 2002. Centers for Disease Control and Prevention. Incorporating HIV Prevention into the Medical Care of Persons Living with HIV. MMWR. 52(RR12):1-24. July 18, 2003. Available at: http://www.cdc.gov/hiv/ pubs/guidelines.htm#prevention. Hecht FM, Wilson IB, Wu AW, et al. Society of General Internal Medicine AIDS Task Force. Optimizing care for persons with HIV infection. Ann Intern Med. 1999;131:136-143. Nerad J, Romeyn M, Silverman E, et al. General nutrition management in patients infected with human immunodeficiency virus. Clinical Infect Dis. 2003;36(Suppl. 2):S52-62. Sande MA, Volberding PA, Eds. The Medical Management of AIDS – 6th ed. Philadelphia, PA: WB Saunders; 1999. 3 WEBSITES AIDSInfo: http://www.aidsinfo.com Accessed 9/03. AIDS Education Global Information System: http:// www.aegis.com Accessed 9/03. Centers for Disease Control and Prevention Division of HIV/AIDS Prevention: http:// www.cdc.gov/hiv/dhap.htm Accessed 10/03. HIVInsite: http://www.hivinsite.ucsf.edu Accessed 10/03. Johns Hopkins AIDS Service: http:// www.hopkins-aids.edu Accessed 10/03. STD/HIV Prevention Training Centers: http:// depts.washington.edu/nnptc/ Accessed 10/03. U.S. Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau 19
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