HIV Medicine Association
View all recommendations from this societyReleased February 8, 2016
Don’t order complex lymphocyte panels when ordering CD4 counts.
Order only CD4 counts and percentages rather than ordering other lymphocyte panels. For example, CD8 testing, including the CD4/CD8 ratio, adds cost without providing useful information. More complex lymphocyte panels are unnecessary and increase costs even more.
1 These recommendations do not supersede grant reporting requirements. 2 Note: Some patients may still require a face to face visit every three to four months to make certain that other comorbid conditions are stable, and to assess if there are other social changes that might have surfaced which could impact HIV medication adherence. Multidisciplinary practices can consider interim visits with other non-prescribing practitioner team members to support treatment adherence. These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
How The List Was Created
An expert work group composed of four members of HIVMA’s Board of Directors directed the development of HIVMA’s Choosing Wisely list of “Five Things Physicians and Patients Should Question.” The work group was provided with the ABIM Foundation guidelines on recommendation development, and identified a preliminary list of inappropriate and overused clinical practices. A list of five items was drafted and then vetted by the full HIVMA Board of Directors to develop a finalized list of consensus recommendations.
HIVMA’s disclosure and conflict of interest policy can be found at www.hivma.org.
Sources
Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA; Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jan;58(1):1-10.
Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. 2015 Apr. 288 p.
