Primary care key to management of patients with HIV infection

November 14, 2013

[EMBARGOED FOR NOV. 14, 2013, ARLINGTON, Va.] - The HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) has updated its HIV care guidelines to reflect the fact that people with HIV are now living normal life spans, and their physicians need to focus on preventive care, including screening for high cholesterol, diabetes and osteoporosis.

"In many HIV practices now, 80 percent of patients with HIV infection have the virus under control and live long, full lives. This means that HIV specialists need to provide the full spectrum of primary care to these patients, and primary care physicians need a better grasp of the impact HIV care has on routine healthcare," said Judith A. Aberg, MD, lead author of the guidelines and director of the Division of Infectious Diseases and Immunology at the New York University School of Medicine. "Doctors need to tell their HIV-infected patients, 'Your HIV disease is controlled and we need to think about the rest of you.' As with primary care in general, it's about prevention."

"Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus," an update on HIVMA's 2009 guidelines, will appear in print in January in Clinical Infectious Diseases. Reflecting changes in the HIV landscape, the guidelines note patients whose HIV is under control should have their blood monitored for levels of the virus every six to 12 months, rather than every three to four months as previously recommended.

People with HIV are at increased risk for common health conditions, such as high cholesterol and triglycerides, due to the infection itself, ART or traditional risk factors such as smoking and eating unhealthy foods, and doctors must be vigilant about monitoring those levels.

The guidelines include new recommendations for screening for diabetes, osteoporosis and colon cancer, and suggest patients with HIV infection should be vaccinated against pneumococcal infection, influenza, varicella and hepatitis A and B. A table outlining interactions between specific antiretrovirals and statins (the medications commonly used for lipid management) is also included. There also is a more robust section on sexually transmitted diseases, including a recommendation for annual screening of trichomoniasis in women and yearly screening for gonorrhea and chlamydia for all who may be at risk.

The guidelines authors note that doctors should consistently discuss and counsel patients on their sexual history (current and past) and any risky behaviors, such as the use of illicit drugs, in a nonjudgmental manner and determine how patients are coping with living with HIV infection and if they have a sufficient support network.

HIV-infected patients typically are seen by an HIV specialist or a primary care physician. HIV specialists need to be familiar with primary care issues, and primary care physicians need to be familiar with HIV care recommendations and these guidelines are designed to bridge both gaps, said Dr. Aberg.

"Patients whose HIV is under control might feel they don't need to see a doctor regularly, but adherence is about more than just taking ART regularly; it's also about receiving regular primary care," she said. "These guidelines are designed to help ensure patients with HIV infection live long and healthy lives."

Nearly 1.2 million Americans are living with HIV and approximately 50,000 people are infected each year, according to the Centers for Disease Control and Prevention.
-end-
The six-member HIV guidelines update panel includes specialists in internal medicine, pediatrics and infectious diseases. In addition to Dr. Aberg, the panel includes: Joel E. Gallant, MD, Khalil G. Ghanem, MD, Patricia Emmanuel, MD, Barry S. Zingman, MD, and Michael A. Horberg, MD. As with other IDSA guidelines, the HIV guidelines update will be available in mobile device and pocket-sized quick-reference editions. These and other guideline related products will be made available on the IDSA website at http://www.idsociety.org.

Note: For an advance copy of the HIV guidelines update, to be published in a January issue of Clinical Infectious Diseases, please contact Jerica Pitts at (312) 558-1770 or jpitts@pcipr.com. The guidelines are embargoed until 12:01 a.m. EDT on Nov. 14.

Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty.

The HIV Medicine Association (HIVMA) is the professional home for more than 5,000 physicians, scientists, and other health care professionals dedicated to the field of HIV/AIDS. Nested within the Infectious Diseases Society of America (IDSA), HIVMA promotes quality in HIV care and advocates policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice. For more information, visit http://www.hivma.org.

The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, patient care, prevention, and public health. The Society, which has nearly 10,000 members, was founded in 1963 and is based in Arlington, Va. For more information, see http://www.idsociety.org.

Infectious Diseases Society of America

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.