Test or Intervention |
2013 IDSA Guidelines |
2009 IDSA Guidelines |
Viral load |
Perform every 3-4 months; perform every 6-12 months if clinically and immunologically stable for 2-3 years |
Perform every 3-4 months |
CD4 cell count |
Perform every 3-4 months; perform every 6-12 months if clinically and immunologically stable for 2-3 years |
Perform every 3-4 months |
Fasting glucose and/or HbA1C |
Perform every 6-12 months in all patients; consider HbA1C 5.8% as cutoff for diabetes mellitus |
Perform fasting glucose every 6 months |
Fasting lipid profile |
No change from 2009 recommendations |
Perform every 6-12 months; consider performing 1-3 months after starting or modifying treatment; follow NCEP guidelines* |
Bone Densitometry |
Perform baseline exam in postmenopausal women and men age ≥ 50; periodic monitoring thereafter |
Perform baseline exam in postmenopausal women aged ≥ 65 years and in younger postmenopausal women with 1 or more other risk factor(s) for premature bone loss; consider in persons aged ≥50 years, especially if they have ≥1 risk factor(s) for premature bone loss; periodic monitoring thereafter |
Pneumococcal vaccine |
Patients should receive a dose of PCV13 (Prevnar 13), followed by a dose of PPV23 (Pneumovax) at least 8 weeks later. If previously vaccinated with PPV23, give PCV13 at least 1 year after PPV23; administer to patients with CD4 cell count ≥200 cells/μL. A second PPV23 dose is recommended 5 years after the first PPV23 dose |
Patients should receive PPV23; administer to patients with CD4 cell count >200 cells/uL; consider booster dose 5 years after initial immunization |
HPV vaccine |
Indicated for females age 9–26 and males age 9–26 |
Indicated for females aged 9–26 years but may consider in other groups |
Anal Pap test |
Anal Pap test should be performed in MSM, women with a history of receptive anal intercourse or abnormal cervical Pap test results, and all HIV-infected persons with genital warts |
Consider if indicated |
Trichomoniasis screening |
Perform annually in all women; repeat testing 3 months later if positive |
Screen at initial visit followed by periodic screening in high-risk groups |
Gonorrhea and chlamydia screening |
Perform annually in patients at risk for STDs; more frequent testing may be indicated in patients at high risk for STDs; repeat testing 3 months later if positive |
Perform annually in patients at risk for STDs;more frequent testing may be indicated in patients at high risk for STDs |