HCV:
The Correctional Conundrum
(continued)
Treatment of HIV- Infected
Women
The initial medical evaluation
of an HIV infected woman should include a thorough past medical history,
social history, and review of systems as outlined in Table I. Given
the high rate of STDs and cervical neoplasia in HIV infected women, physical
examination beyond the standard exam should include pelvic exam with Pap
smear and STD screening (See HIV 101 page 7 and HEPP News, April 2000).
Laboratory evaluation should include screening for other blood borne infections
(Hepatitis B and C), TB exposure (PPD), and baseline hematology and chemistries,
including liver panel (both for baseline prior to beginning therapy, and
to screen for other co-morbid conditions), as well as CD4 counts and HIV
viral load.
By far, the most important
part of the initial encounter with an HIV positive woman is identifying
potential obstacles to adherence with treatment and return to clinic. Before
choosing a specific regimen, clinicians should assess the patientís knowledge
about HIV infection and treatment options, and discuss therapeutic agents,
possible side effects, timing of medications, and the importance of adherence
once therapy is initiated. A critical component of continuing care is linking
the patient with care providers to access once she is released.
CONTINUE...
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