Introduction

This guideline is an update of that produced in 2011 to reflect the advances in knowledge made in the last 4 years. As with the previous monitoring guideline, the aim is to present a consensus regarding the standard assessment and investigation of HIV infection from the time of diagnosis and to describe the appropriate monitoring of HIV-positive individuals both on and off ART. This guideline does not address the investigation and management of specific conditions related to HIV infection nor does it look at the choice of ART as these are all covered in other specific BHIVA guidelines.

Within this guideline, assessment and monitoring of HIV-positive individuals have been categorised into the following areas: initial diagnosis; asymptomatic individuals not yet on ART; ART initiation; initial assessment following commencement of ART; routine monitoring on ART and monitoring in special circumstances.

Summary tables of assessment/monitoring at each of these stages can be found in Section 4 of the Guideline. Following these tables, the evidence underpinning these recommendations, including the strength of evidence, is given in the main text. We have tried to reduce greatly the length of the guideline, especially by heavily relying on other BHIVA guidelines for reference, in order to make it as user-friendly as possible.

Significant changes include the recommendations to reduce/stop CD4 testing in stable patients and to stop performing tests that are no longer of value in an age where most HIV-positive patients are fit and well. We also suggest more consideration for monitoring for age-related conditions such as cardiovascular and bone health using QRisk2 and FRAX scores. Part and parcel of this guideline’s recommendations is the provision of cost-effective care and collaborating with primary care services.

The consultation process will be open for FOUR WEEKS with a deadline for comment of 1730 Monday 11th April. We anticipate that the final guidance will be published online soon afterwards.
 

Downloads

Draft BHIVA guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals (2016)

The consultation period is now closed

Writing Group

Brian Angus (Chair), Gary Brook (Vice-chair)
Funmi Awosusi, Gary Barker, Marta Boffito, Satyajit Das, Esther Dixon-Williams, Lucy Dorrell, Charlotte Hall, Bridie Howe, Sebastian Kalwij, Nashaba Matin, Eleni Nastouli, Frank Post, Melinda Tenant-Flowers, Erasmus Smit, Dan Wheals

Reference

The previous 2011 guidelines can be found by clicking here.