In:
Journal of the International AIDS Society, Wiley, Vol. 15, No. S4 ( 2012-11), p. 1-1
Abstract:
Adequate follow‐up of HIV patients is essential in the cART era. Current guidelines advise regular assessment of the patient, yet the exact content and frequency are less clear and practices vary amongst different hospitals. The objective of this study was to determine the value of performing routine physical examination of patients with normal or near normal immune function, as part of adequate follow‐up. Methods In a cohort of 300 HIV‐1‐infected patients monitored in a large teaching hospital we retrospectively analysed the outcome of routine physical examinations performed at annual check‐ups in 2010. Only stable patients were eligible for inclusion (CD4 count 〉 350 cells/mm 3 if not using cART, CD4 count 〉 100 cells/mm 3 if using cART). Data was collected from the medical records. It was recorded whether or not the physical examination per se was the basis for establishing a new diagnosis. Results Of 300 stable HIV‐1‐infected patients (81% males) with a median age of 47 years old (range 21–79) 216 patients (72%) had physical abnormalities. Lipodystrophy (30%), lymphadenopathy (16%) and hypertension (8.3%) were the most common findings. Two‐thirds of all findings were already known from the past medical history or could be related to current complaints. In 24 patients (8.0%), the physical examination was the basis for establishing a new diagnosis: 6/24 patients (25%) ‐ all men who have sex with men (MSM) ‐ had a concurrent sexually transmitted disease, 8/24 patients (33%) had hypertension. The other 10/24 (42%) patients had a large variety of diagnoses, of which a bradycardia due to a total atrioventricular block was clinically the most relevant diagnosis. Factors associated with the yield of the physical examination could not be identified. Conclusion Routine physical examination per se was the basis for establishing new diagnoses in only 8% of stable HIV infected patients. However, most diagnoses were of little clinical relevance, suggesting that the additional value of routine physical examination in stable HIV patients is limited. Based on our findings, the regular standard assessment could be restricted to measuring blood pressure and the performance of anogenital examination in MSM.
Type of Medium:
Online Resource
ISSN:
1758-2652
,
1758-2652
DOI:
10.7448/IAS.15.6.18125
Language:
English
Publisher:
Wiley
Publication Date:
2012
detail.hit.zdb_id:
2467110-1
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