BC Centre in HIV/AIDS Primary Care Guidelines

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1.3 HIV-Specific Testing

See also: 2.3 Monitoring

 TestBaselineFollow-up Before Antiretroviral InitiationFirst 2 Years After Antiretroviral InitiationAfter 2 Years on Stable Suppressive ARV Therapy
HIV Infection Status HIV antibody diagnostic test (ELISA, Western blot) If not already available      
CD4 Count CD4 cell count, absolute and percentage Every 3 – 4 months
Monthly until pVL<40 copies/mL, then every 3 – 6 months
Every 6 months; once CD4 is consistently >350 cells/µL, CD4 monitoring is optional
Viral Load Quantitative plasma HIV RNA Every 6 months
Resistance Testing HIV Genotypic drug resistance (At the time of first HIV pVL; can be done on stored plasma sample) Shortly before ARV initiation Test if pVL rebounds (to >250 copies/mL) after initial suppression, or pVL fails to suppress to <250 copies/mL Test if pVL rebounds to >250 copies/mL
Screen For Risk Of ABC HSR HLA-B*5701 Before initiating or restarting therapy with ABC, if not previously done. Test patients not previously screened and currently taking
ABC; patients stopping ABC therapy who are HLA-B*5701 positive are at a high risk of HSR and should not restart ABC therapy
Test patients not previously screened and currently taking
ABC; patients stopping ABC therapy who are HLA-B*5701 positive are at a high risk of HSR and should not restart ABC therapy
Tropism Testing Coreceptor tropism testing   When considering a CCR5 antagonist When considering a CCR5 antagonist as an ARV switch or for treatment failure When considering a CCR5 antagonist as an ARV switch or for treatment failure

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