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Initial evaluation of the HIV-infected adult

Howard Libman, MD, FACP
Todd M Pollack, MD
Section Editor
John G Bartlett, MD
Deputy Editor
Allyson Bloom, MD


The initial evaluation of the HIV-infected adult is comprehensive and may take place over several visits. Its goals are to assess the stage of HIV disease, determine the risk for other infections, identify co-morbidities that are associated with HIV infection, and evaluate for the initiation and selection of antiretroviral therapy. In addition, the initial evaluation is an important time to establish the patient-practitioner relationship and educate the patient about the natural history and management of HIV infection.

This topic discusses the elements of the initial evaluation of patients with HIV infection. Primary care of the HIV-infected patient is discussed elsewhere. (See "Primary care of the HIV-infected adult".)


In the United States, the HIV Medicine Association of the Infectious Diseases Society of America has published guidelines on the primary care of HIV-infected individuals, which were last updated in 2013 [1]. The recommendations discussed in this topic are generally consistent with these guidelines.

Links to recommendations by other expert groups, including the European AIDS Clinical Society [2], can be found in the society guideline links topic. (See 'Society guideline links' below.)


Patients with a prior history of HIV infection — In patients who present at their initial visit with a prior history of HIV infection, efforts should be made to obtain documentation of HIV antibody or HIV RNA testing in the past. If these records are not available, repeat HIV antibody testing should be performed to confirm the diagnosis since cases of factitious HIV infection have been reported [3]. (See 'HIV serology' below.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 07, 2017.
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