What is the focus of the clinical history in suspected HIV infection?

Updated: Apr 09, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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A detailed review of symptoms and a complete physical examination should be performed. [10]

Specific information to gather should include the date of the first positive HIV test, as well as the date of the most recent HIV care visit.

The most important laboratory information for the PCP is the documentation of the patient’s most recent CD4 count and HIV viral load, as these serve as predictors of possible opportunistic infections upon presentation, or for which prophylaxis is needed.

Other information to gather includes medication history, including antiretrovirals (ARVs) and immunization status (reviewed below), and sexual history, including previous sexually transmitted infections (STIs).

Health-related behaviors such as tobacco abuse, alcohol use, drug use, and exercise and diet should be detailed and counseled appropriately.

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