array:23 [ "pii" => "S0213005X18301678" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2018.03.011" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "1837" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Enferm Infecc Microbiol Clin. 2019;37:467-75" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 572 "formatos" => array:2 [ "HTML" => 322 "PDF" => 250 ] ] "itemSiguiente" => array:18 [ "pii" => "S0213005X19300205" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2019.01.005" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "1983" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2019;37:476-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 373 "formatos" => array:2 [ "HTML" => 277 "PDF" => 96 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Diagnosis at first sight</span>" "titulo" => "Necrotic skin ulcers in an immunocompromised patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "476" "paginaFinal" => "479" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlceras de piel necróticas en un paciente inmunocomprometido" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1939 "Ancho" => 955 "Tamanyo" => 284858 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Skin biopsy culture. (A) Culture with dark-gray cottony colonies of <span class="elsevierStyleItalic">Mucor</span> spp., macroscopic morphology on Sabouraud Dextrose Agar. (B) Large spherical sporangia (arrowheads) and pronounced columellae with sporangiospores, in the absence of rhizoids (microscopic morphology on Lactophenol cotton blue stain, 100×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Oscar Morado-Aramburo, Edgar Ortiz-Brizuela, Silvia Méndez-Flores, Jennifer Cuellar-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Oscar" "apellidos" => "Morado-Aramburo" ] 1 => array:2 [ "nombre" => "Edgar" "apellidos" => "Ortiz-Brizuela" ] 2 => array:2 [ "nombre" => "Silvia" "apellidos" => "Méndez-Flores" ] 3 => array:2 [ "nombre" => "Jennifer" "apellidos" => "Cuellar-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X19300205?idApp=UINPBA00004N" "url" => "/0213005X/0000003700000007/v1_201907280647/S0213005X19300205/v1_201907280647/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0213005X19300023" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2018.12.008" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "1975" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Enferm Infecc Microbiol Clin. 2019;37:458-66" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3954 "formatos" => array:2 [ "HTML" => 2750 "PDF" => 1204 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Formación médica continuada: infecciones de transmisión sexual</span>" "titulo" => "Infección gonocócica: un problema aún sin resolver" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "458" "paginaFinal" => "466" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gonococcal infection: An unresolved problem" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Jesús Barberá, Judit Serra-Pladevall" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Maria Jesús" "apellidos" => "Barberá" ] 1 => array:2 [ "nombre" => "Judit" "apellidos" => "Serra-Pladevall" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X19301169" "doi" => "10.1016/j.eimce.2018.12.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X19301169?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X19300023?idApp=UINPBA00004N" "url" => "/0213005X/0000003700000007/v1_201907280647/S0213005X19300023/v1_201907280647/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Executive summary</span>" "titulo" => "Executive summary of the GeSIDA consensus document on control and monitoring of HIV-infected patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "467" "paginaFinal" => "475" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "" "autores" => array:1 [ 0 => array:2 [ "colaborador" => "AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Complexo Hospitalario Universitario/IIS Galicia Sur, Clara Campoamor, Pontevedra, Vigo, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resumen ejecutivo del Documento de consenso de GeSIDA sobre el control y la monitorización de la infección por el VIH" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Herein, we summarize the recommendations of the AIDS Study Group (GeSIDA) on the control and monitoring of adult patients infected with HIV.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> These recommendations complement those on antiretroviral therapy (ART) in adults with HIV infection, updated annually by GESIDA and the National AIDS Plan.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical evaluation</span><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0015" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0020" class="elsevierStylePara elsevierViewall">The clinical evaluation of the HIV-infected patient should include a full history (with sociodemographic, occupational, personal, and familial data) (A-II) and an exhaustive, detailed physical examination (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0025" class="elsevierStylePara elsevierViewall">A series of additional steps are recommended, as follows:</p></li></ul><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0030" class="elsevierStylePara elsevierViewall">Inform the patient about HIV infection, make recommendations for preventing transmission of HIV and other STIs, and promote a healthy lifestyle (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0035" class="elsevierStylePara elsevierViewall">Start contact tracing where possible (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">•</span><p id="par0040" class="elsevierStylePara elsevierViewall">Offer psychological support to those patients who need it (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">•</span><p id="par0045" class="elsevierStylePara elsevierViewall">Prepare patients for initiation of ART (A-III).</p></li></ul><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">Successive check-ups should include questions about health problems, adherence and tolerability to ART, risk of other STIs, and substance abuse. A physical examination should be performed depending on the patient's symptoms, comorbid conditions, and the risk of developing opportunistic infections or immune reconstitution inflammatory syndrome (A-II).</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Laboratory work-up</span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the additional tests recommended at the initial evaluation and follow-up visits.<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">HIV-1/2 serology testing should be performed in all cases where HIV infection has not been confirmed and PVL is undetectable (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">The initial laboratory evaluation should include a complete blood count, general plasma biochemistry, serology, and specific tests for HIV infection (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">The HLA-B*5701 allele should be determined in all patients before starting an ART regimen that contains ABC (A-I). ABC should not be prescribed if the result of the HLA-B*5701 test is positive (A-I).</p></li></ul></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Analysis of lymphocyte populations</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0085" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">The absolute number and percentage of CD4+ lymphocytes should be determined before starting ART. Once ART has been initiated, these parameters should be assessed at 3 months (A-III) and every 3–6 months thereafter in order to monitor the immune response (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">If the patient does not follow a course of ART, then the CD4+ lymphocyte count should be monitored every 3–6 months (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">At the physician's discretion, the interval between check-ups can be longer in clinically stable patients with suppressed viral load and a CD4+ lymphocyte count >300<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span> (C-II).</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Analysis of plasma viral load</span><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0110" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">-</span><p id="par0115" class="elsevierStylePara elsevierViewall">PVL should be determined before initiating ART and at 4 weeks after initiation. Once virological suppression (<50<span class="elsevierStyleHsp" style=""></span>copies/mL of HIV-RNA) has been achieved, PVL should be monitored every 3–6 months (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">-</span><p id="par0120" class="elsevierStylePara elsevierViewall">The objective of virological suppression is a PVL <50<span class="elsevierStyleHsp" style=""></span>copies/mL (A-II).</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Study of resistance to antiretroviral drugs and viral tropism</span><p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0130" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">-</span><p id="par0135" class="elsevierStylePara elsevierViewall">Perform an HIV resistance genotyping study, including the reverse transcriptase and protease genes, in all patients before initiation of ART. However, it is only necessary to wait for the result in cases where an NNRTI is to be used (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">-</span><p id="par0140" class="elsevierStylePara elsevierViewall">The integrase gene should only be studied if there is a high degree of suspicion of transmission of resistance to this family (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">-</span><p id="par0145" class="elsevierStylePara elsevierViewall">Perform a genotyping study to determine HIV-1 resistance in all patients who experience virological failure. The study should include the integrase gene if the regimen includes an INI (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">-</span><p id="par0150" class="elsevierStylePara elsevierViewall">HIV-1 tropism should be determined in cases where a CCR5 receptor antagonist is to be prescribed or in cases where the regimen containing this drug has failed (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">-</span><p id="par0155" class="elsevierStylePara elsevierViewall">In patients with a viral load <500<span class="elsevierStyleHsp" style=""></span>copies/ml, resistance in plasma can be investigated using plasma concentration methods (B-II) or a proviral DNA genotyping study (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">-</span><p id="par0160" class="elsevierStylePara elsevierViewall">Minority variants should be interpreted on an individual basis for each drug according to their genetic barrier (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">-</span><p id="par0165" class="elsevierStylePara elsevierViewall">The results should be interpreted taking into account all previous genotyping studies the patient has undergone (B-II).</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Determination of plasma concentrations of antiretroviral drugs</span><p id="par0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0175" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">-</span><p id="par0180" class="elsevierStylePara elsevierViewall">Determination of the plasma concentration of antiretroviral drugs is not indicated in daily clinical practice, but is reserved for clinical studies/trials or special clinical situations (BII).</p></li></ul></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Evaluation of kidney function</span><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0190" class="elsevierStylePara elsevierViewall">All HIV-infected patients should undergo a basic kidney work-up (plasma creatinine, estimated glomerular filtration rate [CKD-EPI formula], serum phosphate, urine protein-to-creatinine ratio, glycosuria, urine sediment) to test for kidney disease at the baseline visit after diagnosis of HIV infection. The work-up should be performed systematically during subsequent follow-up visits (A-II).</p><p id="par0195" class="elsevierStylePara elsevierViewall">Patients with no risk factors for kidney disease should undergo a basic kidney work-up once per year. Patients with risk factors for kidney disease should undergo an extended kidney work-up at least every 6 months (C-III).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Evaluation of bone mineral density</span><p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0205" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0045"><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">-</span><p id="par0210" class="elsevierStylePara elsevierViewall">DXA should be performed in HIV-infected patients fulfilling any of the following conditions (B-III).</p></li></ul><ul class="elsevierStyleList" id="lis0050"><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">a.</span><p id="par0215" class="elsevierStylePara elsevierViewall">Presence of major risk factors for fracture (long-term therapy with corticosteroids, history of fragility fracture, high risk of falling).</p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">b.</span><p id="par0220" class="elsevierStylePara elsevierViewall">Postmenopausal women or men with confirmed hypogonadism.</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">c.</span><p id="par0225" class="elsevierStylePara elsevierViewall">Men aged ≥50 years.</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">d.</span><p id="par0230" class="elsevierStylePara elsevierViewall">Cases where the FRAX algorithm indicates a >3% risk of hip fracture and/or >10% risk of major osteoporotic fracture in the following 10 years.</p></li></ul><ul class="elsevierStyleList" id="lis0055"><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">a.</span><p id="par0235" class="elsevierStylePara elsevierViewall">In patients who do not have osteoporosis, DXA should be repeated following the sequence set out below (B-III):</p></li></ul><ul class="elsevierStyleList" id="lis0060"><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">-</span><p id="par0240" class="elsevierStylePara elsevierViewall">If the BMD value is normal or slightly reduced (<span class="elsevierStyleItalic">t</span>-score at any site ≤−1.5 SD): repeat after 10 years.</p></li><li class="elsevierStyleListItem" id="lsti0155"><span class="elsevierStyleLabel">-</span><p id="par0245" class="elsevierStylePara elsevierViewall">In cases of moderate osteopenia (<span class="elsevierStyleItalic">t</span>-score between −1.50 and −1.99 SD) at 5 years.</p></li><li class="elsevierStyleListItem" id="lsti0160"><span class="elsevierStyleLabel">-</span><p id="par0250" class="elsevierStylePara elsevierViewall">In cases of advanced osteopenia (<span class="elsevierStyleItalic">t</span>-score between −2.00 and −2.49 SD): repeat every 1–2 years.</p></li></ul><ul class="elsevierStyleList" id="lis0065"><li class="elsevierStyleListItem" id="lsti0165"><span class="elsevierStyleLabel">-</span><p id="par0255" class="elsevierStylePara elsevierViewall">The risk of fracture should be evaluated using the FRAX algorithm in patients with osteoporosis, especially if specific treatment is being considered (B-II).</p></li></ul></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Evaluation of metabolism</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Recommendation</span><p id="par0260" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0070"><li class="elsevierStyleListItem" id="lsti0170"><span class="elsevierStyleLabel">-</span><p id="par0265" class="elsevierStylePara elsevierViewall">The lipid profile and glycemia should be evaluated with other cardiovascular risk factors at least once per year in all HIV-infected patients (B-II).</p></li></ul></p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Evaluation of cardiovascular risk</span><p id="par0270" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span> (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>)</p><p id="par0275" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0075"><li class="elsevierStyleListItem" id="lsti0175"><span class="elsevierStyleLabel">-</span><p id="par0280" class="elsevierStylePara elsevierViewall">Classic cardiovascular risk factors and a family history of premature cardiovascular disease should be evaluated (AII).</p></li><li class="elsevierStyleListItem" id="lsti0180"><span class="elsevierStyleLabel">-</span><p id="par0285" class="elsevierStylePara elsevierViewall">Nonclassic risk factors should also be assessed (illicit drug use and composition of ART regimen) (AIII).</p></li><li class="elsevierStyleListItem" id="lsti0185"><span class="elsevierStyleLabel">-</span><p id="par0290" class="elsevierStylePara elsevierViewall">ACC/AHA guidelines recommend evaluating 10-year cardiovascular risk in the following in persons aged 40–79 years (BII).</p></li><li class="elsevierStyleListItem" id="lsti0190"><span class="elsevierStyleLabel">-</span><p id="par0295" class="elsevierStylePara elsevierViewall">Evaluations should be repeated annually (BIII).</p></li></ul></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Diagnosis of latent tuberculosis infection (LTBI)</span><p id="par0300" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0305" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0080"><li class="elsevierStyleListItem" id="lsti0195"><span class="elsevierStyleLabel">-</span><p id="par0310" class="elsevierStylePara elsevierViewall">All HIV-infected patients should undergo screening for LTBI at diagnosis of their HIV infection (AI). Screening should be by tuberculin skin test or interferon gamma release assay (BIII).</p></li><li class="elsevierStyleListItem" id="lsti0200"><span class="elsevierStyleLabel">-</span><p id="par0315" class="elsevierStylePara elsevierViewall">Screening for LTBI should be repeated in patients with <200 CD4+ cells/μL and an initial negative test result once this CD4+ threshold is surpassed with ART (BII).</p></li><li class="elsevierStyleListItem" id="lsti0205"><span class="elsevierStyleLabel">-</span><p id="par0320" class="elsevierStylePara elsevierViewall">Screening for LTBI should be repeated in patients with a negative result in the baseline test and risk of exposure to TB (AII).</p></li><li class="elsevierStyleListItem" id="lsti0210"><span class="elsevierStyleLabel">-</span><p id="par0325" class="elsevierStylePara elsevierViewall">Regular, systematic screening is not recommended in patients with a negative test result at baseline and no evidence of risk factors for TB and who are receiving ART (BIII).</p></li></ul></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Diagnosis of viral hepatitis</span><p id="par0330" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0335" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0085"><li class="elsevierStyleListItem" id="lsti0215"><span class="elsevierStyleLabel">-</span><p id="par0340" class="elsevierStylePara elsevierViewall">The initial evaluation of HIV-infected patients should include testing for HCV antibodies (AI). If the result is positive, plasma viral load should be measured to determine the activity of the infection (AI). Patients with active infection should undergo viral subtyping and genotyping (AI).</p></li><li class="elsevierStyleListItem" id="lsti0220"><span class="elsevierStyleLabel">-</span><p id="par0345" class="elsevierStylePara elsevierViewall">HCV serology testing should be repeated annually in patients with no previous history of HCV infection who engage in risk practices. HCV-RNA should be determined annually to assess the possibility of HCV reinfection in patients with an SVR who engage in risk practices (AII).</p></li><li class="elsevierStyleListItem" id="lsti0225"><span class="elsevierStyleLabel">-</span><p id="par0350" class="elsevierStylePara elsevierViewall">Serology testing should be performed to screen for HBV (HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe) in all HIV-infected patients (AI). HBV-DNA should be assessed in patients with positive HBsAg (AI). In the case of isolated anti-HBc positivity, the presence of occult hepatitis B should be investigated by determining HBV-DNA in serum (BII).</p></li><li class="elsevierStyleListItem" id="lsti0230"><span class="elsevierStyleLabel">-</span><p id="par0355" class="elsevierStylePara elsevierViewall">HBV viral load should be monitored every 6 months in patients with active infection (BIII).</p></li><li class="elsevierStyleListItem" id="lsti0235"><span class="elsevierStyleLabel">-</span><p id="par0360" class="elsevierStylePara elsevierViewall">All patients with active HBV infection should undergo serology testing for HDV. If the result is positive, HDV-RNA should be assessed (AI).</p></li><li class="elsevierStyleListItem" id="lsti0240"><span class="elsevierStyleLabel">-</span><p id="par0365" class="elsevierStylePara elsevierViewall">All patients should undergo serology testing for HAV at the beginning of follow-up to evaluate the need for vaccination (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0245"><span class="elsevierStyleLabel">-</span><p id="par0370" class="elsevierStylePara elsevierViewall">Possible HEV infection should only be investigated in cases of clinical suspicion (A-II).</p></li></ul></p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Evaluation of liver fibrosis</span><p id="par0375" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0090"><li class="elsevierStyleListItem" id="lsti0250"><span class="elsevierStyleLabel">-</span><p id="par0380" class="elsevierStylePara elsevierViewall">Fibrosis stage should be evaluated in patients with chronic hepatitis caused by HBV and/or HCV (AI).</p></li><li class="elsevierStyleListItem" id="lsti0255"><span class="elsevierStyleLabel">-</span><p id="par0385" class="elsevierStylePara elsevierViewall">The initial evaluation of fibrosis should be made using noninvasive methods (AI). Transient elastometry is the noninvasive technique of choice in those centers where it is available (AI).</p></li><li class="elsevierStyleListItem" id="lsti0260"><span class="elsevierStyleLabel">-</span><p id="par0390" class="elsevierStylePara elsevierViewall">Liver stiffness should be evaluated regularly—ideally annually—in all patients with active HBV/HCV infection (AII).</p></li></ul></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Follow-up of patients with liver cirrhosis</span><p id="par0395" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span> (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>)</p><p id="par0400" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0095"><li class="elsevierStyleListItem" id="lsti0265"><span class="elsevierStyleLabel">-</span><p id="par0405" class="elsevierStylePara elsevierViewall">HIV-infected patients with liver cirrhosis (any cause) should be evaluated at least every 6 months. The evaluation should include a clinical examination, a laboratory work-up with liver function parameters, and calculation of the Child-Pugh and MELD indices (AIII). Annual assessment of liver stiffness is also recommended (AII).</p></li><li class="elsevierStyleListItem" id="lsti0270"><span class="elsevierStyleLabel">-</span><p id="par0410" class="elsevierStylePara elsevierViewall">HIV-infected patients with liver cirrhosis (any cause) should undergo systematic screening for hepatocellular carcinoma at diagnosis of cirrhosis (AI). Patients with chronic HBV infection and risk factors for hepatocellular carcinoma (Asian males aged >40 years, Asian women aged >50 years, Africans, and patients with a family history of hepatocellular carcinoma) should undergo screening even if they do not have cirrhosis (AIII). Screening for hepatocellular cirrhosis is by ultrasound examination every 6 months (AI).</p></li><li class="elsevierStyleListItem" id="lsti0275"><span class="elsevierStyleLabel">-</span><p id="par0415" class="elsevierStylePara elsevierViewall">Patients with cirrhosis should undergo screening for esophageal varices using upper digestive endoscopy at diagnosis of cirrhosis (AII). Patients with liver stiffness <21<span class="elsevierStyleHsp" style=""></span>kPa can be managed without endoscopy; liver stiffness should be assessed annually (AII).</p></li></ul></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Diagnosis of other STIs. Cervical cytology screening in women. Detection of papillomavirus and anal dysplasia in men</span><p id="par0420" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span> (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>)</p><p id="par0425" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0100"><li class="elsevierStyleListItem" id="lsti0280"><span class="elsevierStyleLabel">-</span><p id="par0430" class="elsevierStylePara elsevierViewall">Screening for STIs is recommended at the baseline visit and annually thereafter, or more frequently depending on the individual evaluation of risk (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0285"><span class="elsevierStyleLabel">-</span><p id="par0435" class="elsevierStylePara elsevierViewall">All women should undergo cervical cytology and screening for human papillomavirus (HPV) at the baseline visit. Subsequent check-ups should be scheduled based on the initial findings (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0290"><span class="elsevierStyleLabel">-</span><p id="par0440" class="elsevierStylePara elsevierViewall">Digital rectal examination and cytology are the methods used for screening of preneoplastic lesions and/or carcinoma of the anal canal (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0295"><span class="elsevierStyleLabel">-</span><p id="par0445" class="elsevierStylePara elsevierViewall">Annual anal cytology is recommended for all men who have sex with men, women with cervical dysplasia, and patients with genital warts (B-III).</p></li></ul></p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Preventive strategies for reducing sexual risk practices and drug consumption practices</span><p id="par0450" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0455" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0105"><li class="elsevierStyleListItem" id="lsti0300"><span class="elsevierStyleLabel">-</span><p id="par0460" class="elsevierStylePara elsevierViewall">Patients should receive health education in order to reduce sexual risk practices and drug consumption practices (AII).</p></li><li class="elsevierStyleListItem" id="lsti0305"><span class="elsevierStyleLabel">-</span><p id="par0465" class="elsevierStylePara elsevierViewall">Antiviral treatment should be used to prevent new infections by HBV, HCV, and HIV (AI).</p></li><li class="elsevierStyleListItem" id="lsti0310"><span class="elsevierStyleLabel">-</span><p id="par0470" class="elsevierStylePara elsevierViewall">The use of condoms—both male and female—should be encouraged (AI).</p></li><li class="elsevierStyleListItem" id="lsti0315"><span class="elsevierStyleLabel">-</span><p id="par0475" class="elsevierStylePara elsevierViewall">Harm reduction programs should be implemented for drug users (AI).</p></li></ul></p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Screening of imported diseases in immigrant patients</span><p id="par0480" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span> (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>)</p><p id="par0485" class="elsevierStylePara elsevierViewall">All persons from endemic areas should undergo screening for <span class="elsevierStyleItalic">Trypanosoma cruzi</span>, especially in the case of compatible signs or symptoms (AII).</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0490" class="elsevierStylePara elsevierViewall">Persons from endemic areas or those who have spent long periods of residence in an endemic area should undergo screening for strongyloidosis, especially if they have eosinophilia (AII).</p><p id="par0495" class="elsevierStylePara elsevierViewall">PCR should be performed to detect malaria in high-risk persons 2 years after leaving the endemic area (BIII).</p><p id="par0500" class="elsevierStylePara elsevierViewall">Persons from endemic areas should undergo screening for schistosomiasis, especially if they report bathing in fresh water or have eosinophilia (AIII).</p><p id="par0505" class="elsevierStylePara elsevierViewall">Persons from tropical areas should undergo screening for parasites in stool during the 2 years following their return (AIII).</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Vaccination</span><p id="par0510" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span> (<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>)</p><p id="par0515" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0110"><li class="elsevierStyleListItem" id="lsti0320"><span class="elsevierStyleLabel">-</span><p id="par0520" class="elsevierStylePara elsevierViewall">HIV-infected adults who have not been vaccinated against pneumococcus should receive a dose of PCV13 (<span class="elsevierStyleItalic">A</span>-<span class="elsevierStyleItalic">II</span>), followed, at least 8 weeks later, by a dose of PPV23 (<span class="elsevierStyleItalic">A-II</span>). Patients previously vaccinated with PPV-23 can choose to be vaccinated with PCV13 at least 1 year after the last dose of PPV23 or continue being revaccinated with PPV23 every 5 years (<span class="elsevierStyleItalic">B-III</span>).</p></li><li class="elsevierStyleListItem" id="lsti0325"><span class="elsevierStyleLabel">-</span><p id="par0525" class="elsevierStylePara elsevierViewall">Annual vaccination with nonreplicative (inactivated) influenza vaccine is recommended for all HIV-infected persons, including pregnant women (A-II), and persons in close contact with profoundly immunocompromised HIV-infected patients.</p></li><li class="elsevierStyleListItem" id="lsti0330"><span class="elsevierStyleLabel">-</span><p id="par0530" class="elsevierStylePara elsevierViewall">Vaccination against HPV is recommended (3 doses; 0, 1–2, and 6 months) for all HIV-infected boys and girls aged 9–12 years (A-III) and for persons aged 13–26 years (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0335"><span class="elsevierStyleLabel">-</span><p id="par0535" class="elsevierStylePara elsevierViewall">HIV-infected patients who have not been vaccinated against HBV should be vaccinated with high doses—40<span class="elsevierStyleHsp" style=""></span>μg (0, 1, and 6 months) (A-I) or 20<span class="elsevierStyleHsp" style=""></span>μg (0, 1, 2, and 6 months) (B-I)—after previous initiation of ART.</p></li><li class="elsevierStyleListItem" id="lsti0340"><span class="elsevierStyleLabel">-</span><p id="par0540" class="elsevierStylePara elsevierViewall">Postvaccination anti-HBs levels should be determined. If these are <10<span class="elsevierStyleHsp" style=""></span>IU/L, then 3 new 40-μg doses should be administered at monthly intervals (B-I) or the patient should be revaccinated with the same regimen.</p></li><li class="elsevierStyleListItem" id="lsti0345"><span class="elsevierStyleLabel">-</span><p id="par0545" class="elsevierStylePara elsevierViewall">Patients who have not been vaccinated against HAV should receive monovalent vaccine in 2 doses separated by 6–12 months (A-I). The response to anti-HAV antibodies after vaccination should be evaluated.</p></li><li class="elsevierStyleListItem" id="lsti0350"><span class="elsevierStyleLabel">-</span><p id="par0550" class="elsevierStylePara elsevierViewall">The doses for vaccination against meningococcus in HIV-infected patients are the same as in the general population (B-I).</p></li><li class="elsevierStyleListItem" id="lsti0355"><span class="elsevierStyleLabel">-</span><p id="par0555" class="elsevierStylePara elsevierViewall">Vaccination against VVZ (2 doses separated by 4–8 weeks) is recommended for HIV-infected children older than 12 months and adults, with negative anti-VVZ antibody titers, provided that they have CD4+ lymphocytes ≥15% or ≥200<span class="elsevierStyleHsp" style=""></span>cells/μL, respectively, and are receiving effective ART (B-I).</p></li></ul></p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Early detection of non-AIDS-related cancer</span><p id="par0560" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0565" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0115"><li class="elsevierStyleListItem" id="lsti0360"><span class="elsevierStyleLabel">-</span><p id="par0570" class="elsevierStylePara elsevierViewall">There is no clear evidence to recommend generalized screening for lung cancer using low-radiation chest computed tomography in patients infected by HIV. In centers where screening for lung cancer is performed in the general population, the option should be offered based on the same criteria as in asymptomatic HIV-infected patients (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0365"><span class="elsevierStyleLabel">-</span><p id="par0575" class="elsevierStylePara elsevierViewall">Screening for hepatocellular cancer in cirrhotic patients is based on 6-monthly ultrasound (A-II). Screening should be maintained in HCV-infected cirrhotic patients, even if they have reached SVR to treatment (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0370"><span class="elsevierStyleLabel">-</span><p id="par0580" class="elsevierStylePara elsevierViewall">Periodic check-ups of the oral cavity, skin, and skin adnexa are recommended (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0375"><span class="elsevierStyleLabel">-</span><p id="par0585" class="elsevierStylePara elsevierViewall">HIV-infected patients should be included in the standard tumor screening programs available to the general population (A-III).</p></li></ul></p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Identification and early treatment of cognitive and psychiatric abnormalities</span><p id="par0590" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0595" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0120"><li class="elsevierStyleListItem" id="lsti0380"><span class="elsevierStyleLabel">-</span><p id="par0600" class="elsevierStylePara elsevierViewall">In the case of HIV-infected patients with neurocognitive disorders, it is important to evaluate comorbid conditions (e.g., psychiatric diseases, drug consumption, and HCV coinfection) that may be the cause or act as triggers of the disorder (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0385"><span class="elsevierStyleLabel">-</span><p id="par0605" class="elsevierStylePara elsevierViewall">In the diagnosis of HAND, causes other than HIV infection should be ruled out, a neuropsychological examination should be performed, and interference with activities of daily living should be evaluated (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0390"><span class="elsevierStyleLabel">-</span><p id="par0610" class="elsevierStylePara elsevierViewall">Depression and anxiety disorders should be evaluated in all HIV-infected patients (A-II).</p></li></ul></p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Strategies for avoiding loss to follow-up and for ensuring adherence to ART</span><p id="par0615" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Recommendations:</span></p><p id="par0620" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0125"><li class="elsevierStyleListItem" id="lsti0395"><span class="elsevierStyleLabel">-</span><p id="par0625" class="elsevierStylePara elsevierViewall">Adherence should be monitored and reinforced at all visits to the clinic (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0400"><span class="elsevierStyleLabel">-</span><p id="par0630" class="elsevierStylePara elsevierViewall">Adherence should be monitored by a multidisciplinary team including physicians, nursing staff, psychologists, and hospital pharmacists (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0405"><span class="elsevierStyleLabel">-</span><p id="par0635" class="elsevierStylePara elsevierViewall">Adherence and prescribed drug therapy should be reviewed systematically using a sequential, structured methodology including at least 2 different approaches (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0410"><span class="elsevierStyleLabel">-</span><p id="par0640" class="elsevierStylePara elsevierViewall">Adherence to all prescribed medication—not only ART—should be assessed every 4–6 months in polymedicated patients (≥6 drugs prescribed) and at least once per year in other patients (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0415"><span class="elsevierStyleLabel">-</span><p id="par0645" class="elsevierStylePara elsevierViewall">Annual loss to follow-up should be calculated (per 1000 patient-years), and, depending on the characteristics and facilities of the care unit, more appropriate strategies for minimizing it should be established (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0420"><span class="elsevierStyleLabel">-</span><p id="par0650" class="elsevierStylePara elsevierViewall">In order to minimize loss to follow-up and lack of adherence, we recommend the following (A-II):</p></li></ul><ul class="elsevierStyleList" id="lis0130"><li class="elsevierStyleListItem" id="lsti0425"><span class="elsevierStyleLabel">1.</span><p id="par0655" class="elsevierStylePara elsevierViewall">Creation of specific HIV clinics with a personalized and multidisciplinary approach.</p></li><li class="elsevierStyleListItem" id="lsti0430"><span class="elsevierStyleLabel">2.</span><p id="par0660" class="elsevierStylePara elsevierViewall">Adapting ART to the patient's characteristics.</p></li><li class="elsevierStyleListItem" id="lsti0435"><span class="elsevierStyleLabel">3.</span><p id="par0665" class="elsevierStylePara elsevierViewall">Simplification of ART regimens.</p></li><li class="elsevierStyleListItem" id="lsti0440"><span class="elsevierStyleLabel">4.</span><p id="par0670" class="elsevierStylePara elsevierViewall">Development of joint strategies with the patient.</p></li><li class="elsevierStyleListItem" id="lsti0445"><span class="elsevierStyleLabel">5.</span><p id="par0675" class="elsevierStylePara elsevierViewall">Assessment interviews in special situations.</p></li></ul></p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicts of interest</span><p id="par0680" class="elsevierStylePara elsevierViewall">This consensus document was drafted without grant aid or other funding, whether collective or individual, from any private institutions. The conflicts of interest not associated with this document declared by the Members of the Editorial Board are set out below.</p><p id="par0685" class="elsevierStylePara elsevierViewall">Piedad Arazo has acted as a consultant for Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and has received payment for talks from Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme.</p><p id="par0690" class="elsevierStylePara elsevierViewall">María José Buzón declares that she has no conflicts of interest.</p><p id="par0695" class="elsevierStylePara elsevierViewall">Manuel Crespo has acted as a consultant for AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and has held clinical research grants from Gilead Sciences and ViiV Healthcare. He has received payment for talks from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and for developing training presentations for Bristol-Myers Squibb, Gilead Sciences, and ViiV Healthcare.</p><p id="par0700" class="elsevierStylePara elsevierViewall">Adriá Curran has received grants for attending conferences from Gilead Sciences and Janssen Cilag. He has also received payment for talks and consultancy from Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme and grants for running research projects and biomedical training activities from Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme.</p><p id="par0705" class="elsevierStylePara elsevierViewall">Vicente Estrada has acted as a consultant for Gilead Sciences, ViiV Healthcare, Merck Sharp & Dohme, and Janssen Cilag and has held clinical research grants from Bristol-Myers Squibb, Merck Sharp & Dohme, Gilead Sciences, and Janssen Cilag. He has received payment for talks from Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme.</p><p id="par0710" class="elsevierStylePara elsevierViewall">Federico García has acted as a consultant and given talks for AbbVie, Gilead Sciences, Merck Sharp & Dohme, Roche Diagnostics, and Werfen and has received clinical research grants from Merck Sharp & Dohme and Gilead Sciences.</p><p id="par0715" class="elsevierStylePara elsevierViewall">Arkaitz Imaz has acted as a consultant for Merck Sharp & Dohme and ViiV Healthcare and has held clinical research grants from Gilead Sciences and ViiV Healthcare. He has received payment for talks from AbbVie, Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme and for training presentations from Gilead Sciences. He has also received grants to attend conferences from Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme.</p><p id="par0720" class="elsevierStylePara elsevierViewall">José López Aldeguer has received payment for talks from Gilead Sciences.</p><p id="par0725" class="elsevierStylePara elsevierViewall">Luis López Cortés has received research grants from and acted as a consultant and prepared training presentations for AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0730" class="elsevierStylePara elsevierViewall">Juan Emilio Losa has acted as a consultant for AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and has received payment for talks from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0735" class="elsevierStylePara elsevierViewall">Fernando Lozano has received payment for training presentations from Gilead Sciences, Janssen Cilag, Merck-Sharp & Dome, and ViiV Healthcare.</p><p id="par0740" class="elsevierStylePara elsevierViewall">Mar Masiá has acted as a consultant for Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and received payment for talks from Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0745" class="elsevierStylePara elsevierViewall">Ana Mariño has received grants to attend conferences and scientific meetings from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, and ViiV Healthcare.</p><p id="par0750" class="elsevierStylePara elsevierViewall">Nicolás Merchante has received payment for talks from Bristol-Myers Squibb, Gilead Sciences, and Merck Sharp & Dohme and has received grants to attend conferences from Janssen Cilag, Merck Sharp & Dohme, Gilead Sciences, and ViiV Healthcare.</p><p id="par0755" class="elsevierStylePara elsevierViewall">Antonio Ocampo has received payment for speaking at conferences and consultancy from Fundación Galicia Sur, of which he is a member. He has also received payment for clinical trials and research grants from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0760" class="elsevierStylePara elsevierViewall">Rosario Palacios has acted as a consultant for Bristol-Myers Squibb and ViiV-Healthcare and received payment for training talks from Bristol-Myers Squibb, Merck Sharp & Dohme, Janssen-Cilag, Gilead Sciences, and ViiV-Healthcare.</p><p id="par0765" class="elsevierStylePara elsevierViewall">José A. Pérez-Molina has acted as a consultant for Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. He has also received research grants from Bristol-Myers Squibb, Janssen Cilag, and Merck-Sharp & Dohme and payment for talks from Bristol-Myers Squibb, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0770" class="elsevierStylePara elsevierViewall">Eva Poveda has received grants to attend conferences and scientific meetings from Janssen Cilag, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. She has also received payment for talks from Janssen Cilag and Merck Sharp & Dohme and grants for developing research projects and biomedical training projects from Janssen Cilag and Gilead Sciences.</p><p id="par0775" class="elsevierStylePara elsevierViewall">Melchor Riera has received grants for travel to scientific meetings and conferences from Gilead Sciences, Janssen Cilag, and Merck Sharp & Dohme and payment for talks from AbbVie. He has also received payment for teaching and research from AbbVie and Bristol-Myers Squibb.</p><p id="par0780" class="elsevierStylePara elsevierViewall">Antonio Rivero has acted as a consultant for AbbVie, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare and has held clinical research grants from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. He has received payment for talks from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0785" class="elsevierStylePara elsevierViewall">Rafael Rubio has acted as a consultant for AbbVie, Bristol-Myers Squibb, Gilead Sciences, and Janssen Cilag and has received payment for talks from AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Cilag, Merck Sharp & Dohme, Roche Pharma, and ViiV Healthcare.</p><p id="par0790" class="elsevierStylePara elsevierViewall">Miguel Santín is the principal investigator in a clinical trial on QuantiFERON®-TB Gold In-tube (QFT-GIT), specifically in the contact tracing study, for which Cellestis, Inc. (Carnegie, Australia) provided the QFT-GIT tubes.</p><p id="par0795" class="elsevierStylePara elsevierViewall">Jesús Santos has acted as a consultant for Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag, and ViiV-Healthcare and received payment for training talks from Bristol-Myers Squibb, Merck Sharp & Dohme, Janssen-Cilag, Gilead Sciences, and ViiV-Healthcare.</p><p id="par0800" class="elsevierStylePara elsevierViewall">José Sanz has participated in clinical trials sponsored by Bristol-Myers Squibb and ViiV Healthcare. He has also acted as a consultant and given paid training presentations for AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharp & Dohme, and ViiV Healthcare.</p><p id="par0805" class="elsevierStylePara elsevierViewall">María Jesús Téllez has received grants to attend conferences from Gilead Sciences.</p><p id="par0810" class="elsevierStylePara elsevierViewall">Javier de la Torre has acted as a consultant for Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare and has received payment for talks from AbbVie, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen Cilag, Merck Sharp & Dohme, and ViiV Healthcare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:29 [ 0 => array:3 [ "identificador" => "xres1224914" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1138954" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1224913" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1138955" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical evaluation" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Laboratory work-up" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Analysis of lymphocyte populations" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Analysis of plasma viral load" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Study of resistance to antiretroviral drugs and viral tropism" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Determination of plasma concentrations of antiretroviral drugs" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Evaluation of kidney function" ] 12 => array:2 [ "identificador" => "sec0045" "titulo" => "Evaluation of bone mineral density" ] 13 => array:3 [ "identificador" => "sec0050" "titulo" => "Evaluation of metabolism" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Recommendation" ] ] ] 14 => array:2 [ "identificador" => "sec0060" "titulo" => "Evaluation of cardiovascular risk" ] 15 => array:2 [ "identificador" => "sec0065" "titulo" => "Diagnosis of latent tuberculosis infection (LTBI)" ] 16 => array:2 [ "identificador" => "sec0070" "titulo" => "Diagnosis of viral hepatitis" ] 17 => array:2 [ "identificador" => "sec0075" "titulo" => "Evaluation of liver fibrosis" ] 18 => array:2 [ "identificador" => "sec0080" "titulo" => "Follow-up of patients with liver cirrhosis" ] 19 => array:2 [ "identificador" => "sec0085" "titulo" => "Diagnosis of other STIs. Cervical cytology screening in women. Detection of papillomavirus and anal dysplasia in men" ] 20 => array:2 [ "identificador" => "sec0090" "titulo" => "Preventive strategies for reducing sexual risk practices and drug consumption practices" ] 21 => array:2 [ "identificador" => "sec0095" "titulo" => "Screening of imported diseases in immigrant patients" ] 22 => array:2 [ "identificador" => "sec0100" "titulo" => "Vaccination" ] 23 => array:2 [ "identificador" => "sec0105" "titulo" => "Early detection of non-AIDS-related cancer" ] 24 => array:2 [ "identificador" => "sec0110" "titulo" => "Identification and early treatment of cognitive and psychiatric abnormalities" ] 25 => array:2 [ "identificador" => "sec0115" "titulo" => "Strategies for avoiding loss to follow-up and for ensuring adherence to ART" ] 26 => array:2 [ "identificador" => "sec0120" "titulo" => "Conflicts of interest" ] 27 => array:2 [ "identificador" => "xack419192" "titulo" => "Acknowledgments" ] 28 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1138954" "palabras" => array:6 [ 0 => "Consensus document" 1 => "Human immunodeficiency virus" 2 => "Acquired immune deficiency syndrome" 3 => "Guidelines" 4 => "Recommendations" 5 => "GeSIDA" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1138955" "palabras" => array:6 [ 0 => "Documento de consenso" 1 => "Virus de la inmunodeficiencia humana" 2 => "Síndrome de inmunodeficiencia adquirida" 3 => "Guías" 4 => "Recomendaciones" 5 => "GeSIDA" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The continuous increase in our knowledge of HIV medicine and antiretroviral treatment has led us to draft specific consensus documents focused on topics other than antiretroviral therapy, such as treatment of opportunistic diseases, pre- and post-exposure prophylaxis, metabolic abnormalities, treatment of HBV or HCV coinfection, treatment of patients coinfected with tuberculosis, osteoporosis, kidney disorders, and cardiovascular risk. Accordingly, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology has promoted the drafting of this consensus document on the control and monitoring of adult patients infected with HIV. The document provides recommendations on the initial evaluation and subsequent monitoring of HIV-infected patients that will prove useful for all professionals involved in the management of this infection.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La complejidad creciente de los conocimientos relativos a la infección por el VIH y al tratamiento antirretroviral (TAR) ha condicionado la elaboración de documentos de consenso específicos que abordan aspectos diferentes al TAR. Son ejemplos, la profilaxis y el tratamiento de las infecciones oportunistas, la profilaxis post y pre-exposición, las alteraciones metabólicas y el riesgo cardiovascular, la osteoporosis, los trastornos renales, la co-infección por el VHB y el VHC o el manejo de este en pacientes con tuberculosis, entre otros. En esta línea, la Junta Directiva de GeSIDA ha promovido la elaboración de un documento de consenso sobre el control y la monitorización de los adultos infectados por el VIH. El objetivo de este documento es proporcionar una serie de recomendaciones sobre la evaluación inicial y la posterior monitorización clínica de los pacientes infectados por el VIH, que pueda servir como referencia para todos los profesionales implicados en el cuidado de estos pacientes.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0125">See writing committee in <a class="elsevierStyleCrossRef" href="#sec0125">Appendix A</a>.</p>" "identificador" => "fn1" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:3 [ "apendice" => "<p id="par0820" class="elsevierStylePara elsevierViewall">Writing Committee: Manuel Crespo,<span class="elsevierStyleSup">1</span> Fernando Lozano,<span class="elsevierStyleSup">2</span> María José Buzón,<span class="elsevierStyleSup">3</span> Adriá Curran,<span class="elsevierStyleSup">4</span> Vicente Estrada,<span class="elsevierStyleSup">5</span> Federico García,<span class="elsevierStyleSup">6</span> Arkaitz Imaz,<span class="elsevierStyleSup">7</span> Luis López Cortés,<span class="elsevierStyleSup">8</span> Juan Emilio Losa,<span class="elsevierStyleSup">9</span> Mar Masiá,<span class="elsevierStyleSup">10</span> Nicolás Merchante,<span class="elsevierStyleSup">2</span> Ana Mariño,<span class="elsevierStyleSup">11</span> Antonio Ocampo,<span class="elsevierStyleSup">1</span> José A. Pérez-Molina,<span class="elsevierStyleSup">12</span> Eva Poveda,<span class="elsevierStyleSup">13</span> Melchor Riera,<span class="elsevierStyleSup">14</span> Miguel Santín,<span class="elsevierStyleSup">7</span> Jesús Santos,<span class="elsevierStyleSup">15</span> Eulalia Valencia,<span class="elsevierStyleSup">16</span> Piedad Arazo,<span class="elsevierStyleSup">17</span> Javier de la Torre,<span class="elsevierStyleSup">18</span> José López Aldeguer,<span class="elsevierStyleSup">19</span> Rosario Palacios,<span class="elsevierStyleSup">15</span> Antonio Rivero,<span class="elsevierStyleSup">20</span> Rafael Rubio,<span class="elsevierStyleSup">21</span> José Sanz,<span class="elsevierStyleSup">22</span> María Jesús Téllez.<span class="elsevierStyleSup">5</span></p> <p id="par0825" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">1</span>Complexo Hospitalario Universitario/IIS Galicia Sur, Vigo; <span class="elsevierStyleSup">2</span>Hospital Universitario Virgen de Valme, Sevilla; <span class="elsevierStyleSup">3</span>Vall d́Hebrón Institut de Recerca, Hospital Universitari Vall d́Hebron, Barcelona; <span class="elsevierStyleSup">4</span>Hospital Universitari Vall d’Hebrón, Barcelona; <span class="elsevierStyleSup">5</span>Hospital Clínico Universitario San Carlos, Madrid; <span class="elsevierStyleSup">6</span>Hospital Universitario San Cecilio, Instituto de Investigación Bio-sanitaria, ibsGranada; <span class="elsevierStyleSup">7</span>Hospital Universitario de Bellvitge–IDIBELL, L’Hospitalet de Llobregat, Barcelona; <span class="elsevierStyleSup">8</span>Hospital Universitario Virgen del Rocío–IBIS, Sevilla; <span class="elsevierStyleSup">9</span>Hospital Universitario Fundación Alcorcón. Alcorcón, Madrid; <span class="elsevierStyleSup">10</span>Hospital General Universitario de Elche; <span class="elsevierStyleSup">11</span>Complejo Hospitalario Universitario de Ferrol; <span class="elsevierStyleSup">12</span>Hospital Ramón y Cajal–IRYCIS, Madrid; <span class="elsevierStyleSup">13</span>Complejo Hospitalario Universitario A Coruña–INIBIC, La Coruña; <span class="elsevierStyleSup">14</span>Hospital Son Espases, Palma de Mallorca; <span class="elsevierStyleSup">15</span>Hospital Universitario Virgen de la Victoria–IBIMA, Málaga; <span class="elsevierStyleSup">16</span>Hospital Universitario La Paz. Madrid; <span class="elsevierStyleSup">17</span>Hospital Universitario Miguel Servet, Zaragoza; <span class="elsevierStyleSup">18</span>Hospital Costa del Sol, Marbella; <span class="elsevierStyleSup">19</span>Hospital Universitario La Fe–IISLaFe, Valencia; <span class="elsevierStyleSup">20</span>Hospital Universitario Reina Sofía–IMIBIC, Córdoba; <span class="elsevierStyleSup">21</span>Hospital Universitario 12 Octubre, Instituto de Investigación i+12, Universidad Complutense, Madrid; <span class="elsevierStyleSup">22</span>Hospital Universitario Príncipe de Asturias, Alcalá de Henares.</p>" "etiqueta" => "Appendix A" "identificador" => "sec0125" ] ] ] ] "multimedia" => array:6 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Note: These recommendations are for guidance and can be modified at the discretion of the attending clinician.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">√: Perform.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Test/activity/examination \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Initial evaluation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Follow-up \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology for HIV-1/2 if the infection has not been previously confirmed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complete blood count \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 3–6 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basic coagulation tests \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Plasma biochemistry including liver, kidney (with eGFR), and metabolic profile \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 3–6 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone mineral profile (Ca, P, and vitamin D) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calculation of cardiovascular risk<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 2 years in men >40 years and in women >50 years<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basic urine and sediment analysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biochemistry in a spot urine sample: proteinuria and creatinine-to-protein ratio<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Annually \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Protein profile \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G6PD<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology for HAV (IgG), HBV (HBsAg, HBcAc, HBsAc), HCV, and syphilis<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">e</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In the case of negative results, repeat testing annually if risk factors persist. Confirm HAV and HBV response after vaccination \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology for toxoplasma (IgG) and CMV (IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology for <span class="elsevierStyleItalic">Schistosoma</span>, <span class="elsevierStyleItalic">Trypanosoma cruzi</span>,<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">f</span></a> and <span class="elsevierStyleItalic">Strongyloides stercoralis</span><a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">f</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated (see <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HIV-1 viral load \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At 4 weeks after starting ART and every 3–6 months thereafter<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">g</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determination of CD4+ T lymphocytes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 3–6 months<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">g</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determination of CD8+ T lymphocytes and the CD4+/CD8+ ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional (every 3–6 months<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">g</span></a>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resistance genotyping study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In cases of virological failure \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HLA B*5701 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Viral tropism<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">h</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In cases where MVC is to be used and after virological failure with a CCR5 antagonist \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HCV-RNA<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">i</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">j</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Genotyping for HCV<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">i</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">j</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If suspicion of relapse/reinfection by HCV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HBV-DNA<a class="elsevierStyleCrossRef" href="#tblfn0080"><span class="elsevierStyleSup">k</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 3–6 months if coinfection by HBV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alpha fetoprotein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPD or IGRA<a class="elsevierStyleCrossRef" href="#tblfn0085"><span class="elsevierStyleSup">l</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If the iniital result is negative, consider retesting if the patient come in contact with patients with active TB. Repeat after exposure to a patient with infectious TB, and every 2-3 years in all patients with an initial negative test \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chest radiograph<a class="elsevierStyleCrossRef" href="#tblfn0090"><span class="elsevierStyleSup">m</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver ultrasound<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">j</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 6 months if liver cirrhosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver elastography<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">j</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At least annually if clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Esophagogastroscopy<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">j</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 2–3 years if there are no varices and every 1–2 years in cases of grade I varices \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cervical cytology screening<a class="elsevierStyleCrossRef" href="#tblfn0095"><span class="elsevierStyleSup">n</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If normal, repeat annually \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anal cytology screening<a class="elsevierStyleCrossRef" href="#tblfn0100"><span class="elsevierStyleSup">o</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Electrocardiogram<a class="elsevierStyleCrossRef" href="#tblfn0105"><span class="elsevierStyleSup">p</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone densitometry<a class="elsevierStyleCrossRef" href="#tblfn0110"><span class="elsevierStyleSup">q</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">FRAX (<span class="elsevierStyleInterRef" id="intr0005" href="http://www.shef.ac.uk/FRAX">www.shef.ac.uk/FRAX</span>)<a class="elsevierStyleCrossRef" href="#tblfn0115"><span class="elsevierStyleSup">r</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Screening or STI<a class="elsevierStyleCrossRef" href="#tblfn0120"><span class="elsevierStyleSup">s</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">√ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If clinically indicated \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092295.png" ] ] ] "notaPie" => array:19 [ 0 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Preferably based on the ACC/AHA ASCVD equation (<span class="elsevierStyleInterRef" id="intr0010" href="http://www.cvriskcalculator.com/">www.cvriskcalculator.com</span>), or, where this is not possible, on other equations such as that of Framingham adapted to the HIV-infected population (<span class="elsevierStyleInterRef" id="intr0015" href="http://www.chip.dk/Tools">www.chip.dk/Tools</span>) or the Spanish population (Score: <span class="elsevierStyleInterRef" id="intr0020" href="http://www.heartscore.org;/">www.heartscore.org;</span> Regicor: <span class="elsevierStyleInterRef" id="intr0025" href="http://www.imim.cat/">www.imim.cat</span>).</p>" ] 1 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Annually in cases of previous cardiovascular disease, family history, or increased cardiovascular risk (>10% in the next 10 years).</p>" ] 2 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">If the patient is prescribed TDF, perform 1–3 months after starting treatment and subsequently every 6 months. If the patient has diabetes mellitus or arterial hypertension, determine microalbuminuria and the creatinine–albumin ratio in a spot urine sample.</p>" ] 3 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "d" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Initiate prophylaxis with dapsone or sulfonamide if the patient is from Africa, Asia, or the Mediterranean area.</p>" ] 4 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "e" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Initially, treponemal and nontreponemal tests; subsequently, only nontreponemal test if treponemal test is positive.</p>" ] 5 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "f" "nota" => "<p class="elsevierStyleNotepara" id="npar0030"><span class="elsevierStyleItalic">Schistosoma</span> species, <span class="elsevierStyleItalic">Trypanosoma cruzi</span>, and <span class="elsevierStyleItalic">Strongyloides stercoralis</span> in patients from areas with a high prevalence of infestation, especially if this is suspected (e.g. in the case of eosinophilia) (see <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>).</p>" ] 6 => array:3 [ "identificador" => "tblfn0060" "etiqueta" => "g" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Consider less frequent determination of PVL and CD4+ T lymphocytes (every 6–12 months) in clinically stable patients with repeatedly suppressed plasma viral load and a CD4+ T lymphocyte count repeatedly >300<span class="elsevierStyleHsp" style=""></span>cells/μL (at the physician's discretion).</p>" ] 7 => array:3 [ "identificador" => "tblfn0065" "etiqueta" => "h" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Perform only if the regimen is expected to contain maraviroc.</p>" ] 8 => array:3 [ "identificador" => "tblfn0070" "etiqueta" => "i" "nota" => "<p class="elsevierStyleNotepara" id="npar0045">If HCV coinfection.</p>" ] 9 => array:3 [ "identificador" => "tblfn0075" "etiqueta" => "j" "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Consult AEEH/SEIMC guidelines on management of hepatitis C (<span class="elsevierStyleInterRef" id="intr0030" href="http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2017-ManejoHepatitisC-AEEHySEIMC.pdf">http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2017-ManejoHepatitisC-AEEHySEIMC.pdf</span>) (see <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p>" ] 10 => array:3 [ "identificador" => "tblfn0080" "etiqueta" => "k" "nota" => "<p class="elsevierStyleNotepara" id="npar0055">If HBV coinfection, perform before initiation of ART.</p>" ] 11 => array:3 [ "identificador" => "tblfn0085" "etiqueta" => "l" "nota" => "<p class="elsevierStyleNotepara" id="npar0060">Sensitivity is diminished in severe immunosuppression. The specificity of PPD is diminished in vaccinated patients (BCG); therefore, use IGRA.</p>" ] 12 => array:3 [ "identificador" => "tblfn0090" "etiqueta" => "m" "nota" => "<p class="elsevierStyleNotepara" id="npar0065">Especially in patients from populations with a high prevalence of tuberculosis, patients fulfilling the criteria for chronic bronchitis, and smokers.</p>" ] 13 => array:3 [ "identificador" => "tblfn0095" "etiqueta" => "n" "nota" => "<p class="elsevierStyleNotepara" id="npar0070">If atypical cells are detected, perform colposcopy and biopsy.</p>" ] 14 => array:3 [ "identificador" => "tblfn0100" "etiqueta" => "o" "nota" => "<p class="elsevierStyleNotepara" id="npar0075">Perform initially in all patients with risk practices (homo/bisexual men and women who engage in receptive anal intercourse) and in those with anal or perianal lesions secondary to HPV infection. If the cytology result is abnormal, perform high-resolution anoscopy and biopsy (evidence of benefit unknown, advocated by some experts).</p>" ] 15 => array:3 [ "identificador" => "tblfn0105" "etiqueta" => "p" "nota" => "<p class="elsevierStyleNotepara" id="npar0080">Especially in patients with cardiovascular risk factors and/or patients who are going to initiate therapy with drugs that may affect cardiac conduction.</p>" ] 16 => array:3 [ "identificador" => "tblfn0110" "etiqueta" => "q" "nota" => "<p class="elsevierStyleNotepara" id="npar0085">Identify risk factors for altered bone mineral density. Please see the GESIDA consensus statement on osteoporosis in HIV infection dated May 2016 (<span class="elsevierStyleInterRef" id="intr0035" href="http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2016-osteoporosis.pdf">http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2016-osteoporosis.pdf</span>).</p>" ] 17 => array:3 [ "identificador" => "tblfn0115" "etiqueta" => "r" "nota" => "<p class="elsevierStyleNotepara" id="npar0090">Follow the recommendations of the GESIDA consensus statement on osteoporosis in HIV infection dated May 2016 (<span class="elsevierStyleInterRef" id="intr0040" href="http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2016-osteoporosis.pdf">http://gesida-seimc.org/wp-content/uploads/2017/02/gesida-guiasclinicas-2016-osteoporosis.pdf</span>).</p>" ] 18 => array:3 [ "identificador" => "tblfn0120" "etiqueta" => "s" "nota" => "<p class="elsevierStyleNotepara" id="npar0095">Evaluate the risk of STI and screen for STI following the recommendations of the consensus statement on sexually transmitted infections in children, adolescents, and adults of GESIDA/PNS/GEITS/SEIP, 2017 (<span class="elsevierStyleInterRef" id="intr0045" href="http://gesida-seimc.org/wp-content/uploads/2017/05/gesida-guiasclinicas-ITS-201703.pdf">http://gesida-seimc.org/wp-content/uploads/2017/05/gesida-guiasclinicas-ITS-201703.pdf</span>) (see <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Additional tests in the initial work-up and follow-up of patients with HIV-1 infection.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Evaluation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Interventions \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Subjects \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">History \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Atherosclerotic cardiovascular disease<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Classic cardiovascular risk factors: age, sex, dyslipidemia, arterial hypertension, diabetes, and smoking (current or previous and amount).Nonclassic cardiovascular risk factors: illicit drug consumptionFamily history of early ischemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before initiating ART, and annually \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arterial pressure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arterial pressure (AP).Definition of arterial hypertension: systolic AP >130<span class="elsevierStyleHsp" style=""></span>mmHg or diastolic AP >80<span class="elsevierStyleHsp" style=""></span>mm Hg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before initiating ART, and every 6–12 months, except in specific indications<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lipid profile \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determination of total cholesterol, c-LDL, c-HDL, triglycerides after fasting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before initiating ART, and every 6–12 months, except in specific indications<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glycemic profile \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determination of fasting blood sugar. Oral glucose tolerance test (OGTT) if values 110–125<span class="elsevierStyleHsp" style=""></span>mg/dl.HbA1c in diabetic patients and in prediabetic patients for diagnosis.Definition of diabetes: fasting plasma glucose ≥126<span class="elsevierStyleHsp" style=""></span>mg/dl; or blood sugar ≥200<span class="elsevierStyleHsp" style=""></span>mg/dl 2<span class="elsevierStyleHsp" style=""></span>h after OGTT; or HbA1c ≥6.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before initiating ART, and every 6–12 months, except in specific indications<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ECG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perform ECG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Especially in patients with high cardiovascular risk<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before starting ART, and annually/biannually \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calculation of cardiovascular risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preferably, ACC/AHA 2013 equation, or another cardiovascular risk calculator or identification of the number of traditional cardiovascular risk factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At diagnosis, before initiating ART and annually \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092294.png" ] ] ] "notaPie" => array:4 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0100">Coronary disease or cerebrovascular disease.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0105">The frequency should be higher in patients with major increases in AP, total cholesterol, LDL cholesterol, triglycerides, or glycemia who do not respond to the treatment prescribed.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0110">Also when ART includes drugs that can affect the conduction system.</p>" ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "d" "nota" => "<p class="elsevierStyleNotepara" id="npar0115">The ACC/AHA equation was developed in a population aged 40–79 years. When it was evaluated in an HIV-infected population it had poorer discriminatory capacity in women, black men, and patients with a low-moderate cardiovascular risk (<10%), in whom the rates of acute myocardial infarction observed were greater than expected.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Evaluation of cardiovascular risk in patients with HIV infection.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">CT/MRI, computed tomography/magnetic resonance imaging; LS, liver stiffness; SVR, sustained virological response; UGE, upper gastrointestinal endoscopy.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Objective \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Interval \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Indication \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Remarks \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical and laboratory assessment including liver function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early detection of complications. Monitoring of liver function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 6 months, if the patient is clinically stable. Every 3 months, if the patient has decompensated cirrhosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calculation of Child-Pugh and MELD at each visitIf applicable, evaluation by transplant team \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ultrasound \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Screening for hepatocellular carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Every 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients.Maintain regardless of whether SVR is achieved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alpha fetoprotein is not useful as a screening method.CT/MRI if ultrasound is unclear. If CT/MRI is not conclusive, lesions should be closely monitored \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oral endoscopy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Screening of esophageal varices \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BaselineSubsequently, depending on findings and SVR (Ref. 14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If LS ≥21<span class="elsevierStyleHsp" style=""></span>KPa \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If no esophageal varices in UGE, repeat every 2 years (every 3 if SVR)Do not repeat if no esophageal varices in baseline UGE, subsequent SVR, and decrease in LS <21 kPa \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver elastography \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monitoring LS. Prediction of events. Establish need for UGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AnnuallyMaintain after SVR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Must be repeated annually if UGE not performed because LS <21<span class="elsevierStyleHsp" style=""></span>kPaPerform UGE if progression to LS >21<span class="elsevierStyleHsp" style=""></span>kPa \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092292.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Follow-up of patients with liver cirrhosis.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Etiologic agent \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency of screening \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagnostic technique \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Treponema pallidum</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline evaluation and then annually, or with greater frequency depending on the evaluation of risk (MSM) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology:- Treponemal test (EIA, TPHA)- Nontreponemal test (RPR) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neisseria gonorrhoeae</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline evaluation and then annually, or with greater frequency depending on the evaluation of risk (MSM) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Optic microscopy, culture, or multiplex PCR for gonococcus/<span class="elsevierStyleItalic">Chlamydia</span> (vaginal cytobrush in women; rectal and oropharyngeal cytobrush in MSM). \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Chlamydia trachomatis</span>(serotypes D-K) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline evaluation and then annually, or with greater frequency depending on the evaluation of risk (MSM) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Multiplex PCR for gonococcus/<span class="elsevierStyleItalic">Chlamydia</span> (vaginal cytobrush in women; rectal and oropharyngeal cytobrush in MSM) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Trichomonas vaginalis</span>(only women) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline evaluation and then annually, or with greater frequency depending on the evaluation of risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cervical or vaginal exudate.Optical microscopy and PCR (vaginal cytobrush) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HPV<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>(only women) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cytology and screening of HPV at baseline.If cytology is normal, repeat at 1 year and, after 3 consecutive years with normal results, repeat every 3 years.If <200 CD4+/mm<span class="elsevierStyleSup">3</span>, annual check-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCR for HPV in liquid cervical cytology medium. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092290.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0120">Detection of HPV is not considered a useful test in screening for anal carcinoma in MSM owing to the high prevalence of this disease. In this population, anal cytology is performed under the conditions set out in the text.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">Monitoring of STI in HIV-infected patients.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence in immigrant population \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Regions with greatest prevalence \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Screening method \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T. cruzi</span> infection(15–53%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mexico, Central/South America (especially Bolivia) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Strongyloidosis(2–23%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sub-Saharan Africa, Southeast Asia, Central America, and South America \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identification of parasites in stool (with larva detection techniques).Serology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Schistosomiasis(1–15%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sub-Saharan Africa and Middle East (urinary and intestinal).Southeast Asia (intestinal) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identification of parasites in stool or urine (according to species).Serology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intestinal parasitosis (13–58%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sub-Saharan Africa, Southeast Asia, Central/South America, and Indian subcontinent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identification of parasites in stool (up to 1–2 years after leaving the endemic area) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Malaria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Malaria can be asymptomatic in up to 4.5% of persons from Sub-Saharan Africa \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCR (very low parasitemia) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092293.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0145" class="elsevierStyleSimplePara elsevierViewall">Geographically restricted infections that should be screened for in asymptomatic immigrants.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at6" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Infection \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vaccines available \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Remarks \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pneumococcus</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCV13, 13-valent conjugate vaccine containing 13 capsular polysaccharide pneumococcal antigens, conjugated with a transporter protein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vaccination is recommended without restriction, irrespective of the CD4+ lymphocyte count (although response is better with >200 CD4+/μL), ART, or HIV viral load \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPV23, 23-valent vaccine with nonconjugated polysaccharide capsular antigens of the 23 serotypes of pneumococcus involved in most cases of invasive pneumococcal infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCV13 is administered as a single dose (initially designed for use in children but broad experience in adults) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Influenza</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Contains fractionated inactivated viruses or viral capsid antigens. Its composition is modified according to annual prevalence (WHO) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Parenteral administration, seasonal (annually between September and November), with no restrictions because of CD4+ lymphocyte counts. Efficacy has not been shown to be greater with repeated doses \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Two subtypes of influenza A and 1 or 2 subtypes of influenza B are included (trivalent and tetravalent, respectively) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Human papillomavirus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bivalent vaccine (HPV 16 and 18, associated with 70% of all cases of cervical cancer), tetravalent vaccine (HPV 6, 11, 16, and 18, the first 2 of which are associated with 90% of cases of anogenital warts), and nonavalent vaccine (HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58), recently approved by the FDA and EMA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vaccination is generally recommended until age 26 years. In patients who are already affected, the efficacy of vaccination for reducing the risk of recurrence is questionable. The usefulness of a booster vaccination is unknown \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis B virus (HBV) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Commercial presentations based on viral surface antigen, with different doses (mainly 20 and 40<span class="elsevierStyleHsp" style=""></span>μg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Three high-dose applications (40<span class="elsevierStyleHsp" style=""></span>μg) are recommended, especially if <200 CD4+/μL or high viral load. Four doses (0, 1, 2, and 6 months) have also been recommended, irrespective of the presentation chosen. Monitor anti-HBs antibodies if risk habits persist; administer booster if the titer falls below 10<span class="elsevierStyleHsp" style=""></span>IU/L. If no response is obtained (anti-HBs Ab <10<span class="elsevierStyleHsp" style=""></span>IU/L), despite revaccination, consider inclusion of TDF or TAF in the ART regimen. In anti-HBc+ and anti-HBs– persons, determine HBV DNA. If no evidence of chronic infection, administer complete vaccination schedule \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatitis A virus (HAV) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Whole inactivated virus vaccine with high and long-term immunogenic potency (>10 years). A combined HAV/HBV vaccine is available \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Some authors recommend 3 doses (0, 1, and 6 months) in patients with <350 CD4+ lymphocytes/μL. If a high risk of exposure persists, a booster vaccination can be recommended every 10 years. The response to the combined HAV/HBV vaccine (3 doses) may be weaker in patients with low CD4+ lymphocyte counts or detectable HIV viremia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Meningococcus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monovalent (serogroup C) and tetravalent (serogroups A/C/W/Y), and multicomponent conjugate vaccines (serogroup B). These vaccines induce an efficacious immunogenic response that is specific for each serogroup \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Several regimens are available, and these vary between different expert groups. However, the recommendations applied are those applied to the general population. The tetravalent vaccine (A/C/W/Y) is indicated for high-risk individuals, and booster doses are usually recommended every 5 years if the risk persists \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Varicella zoster virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Varicella virus (prophylaxis of varicella) and zoster vaccine (prophylaxis of herpes zoster and postherpetic neuralgia). Both contain live attenuated virus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Poorly established indications in HIV-infected patients, especially for zoster vaccine. Definitive contraindication of both vaccines in patients with CD4+ lymphocyte counts <200<span class="elsevierStyleHsp" style=""></span>cells/μL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diphtheria/tetanus/pertussis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Trivalent vaccine with diphtheria toxoid, tetanus toxoid, and acellular <span class="elsevierStyleItalic">B. pertussis</span> vaccine (DTPa), or bivalent (DT) (lower quantity of toxoids) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In nonvaccinated adults, the recommended approach is the trivalent vaccine (DTPa) or bivalent vaccine (DT) in 3 doses (0, 2, and 6–12 months) (<span class="elsevierStyleItalic">B-I</span>) and revaccination with DT every 10 years (<span class="elsevierStyleItalic">C-I)</span> (or every 5 years in patients aged >50 years) (<span class="elsevierStyleItalic">C-II</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Measles/mumps/rubella</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Highly immunogenic live attenuated viruses</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Measles may be more severe in very immunodepressed HIV-infected patients; however, the severity of rubella and mumps is similar to that of the general population. Administer 2 doses (with a 4-week interval between them) in HIV-infected adults with negative anti-measles IgG and a CD4+ lymphocyte count >200<span class="elsevierStyleHsp" style=""></span>cells/μL (<span class="elsevierStyleItalic">B-I</span>), who, if possible, are receiving ART (<span class="elsevierStyleItalic">C</span>-<span class="elsevierStyleItalic">II</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Contraindicated in patients with CD4+ lymphocytes <200/μL \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092291.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0150" class="elsevierStyleSimplePara elsevierViewall">Recommended vaccinations in HIV-infected patients.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Documento de consenso de GeSIDA sobre control y monitorización de la infección por el VIH" ] ] "host" => array:2 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2018" "editorial" => "Panel de Expertos de GESIDA" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://gesida-seimc.org/wp-content/uploads/2018/01/gesida_DC_Control_y_Monitorizacion_b23_01_18.pdf" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Documento de consenso de GeSIDA/Plan nacional sobre el SIDA respecto al tratamiento antiretroviral en adultos infectados por el virus de la inmunodeficiencia humana. <a target="_blank" href="http://gesida-seimc.org/documento-de-consenso-de-gesidaplan-nacional-sobre-el-sida-respecto-al-tratamiento-antirretroviral-en-adultos-infectados-por-el-virus-de-la-inmunodeficiencia-humana-actualizacion-enero-2019/">http://gesida-seimc.org/documento-de-consenso-de-gesidaplan-nacional-sobre-el-sida-respecto-al-tratamiento-antirretroviral-en-adultos-infectados-por-el-virus-de-la-inmunodeficiencia-humana-actualizacion-enero-2019/</a>." ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack419192" "titulo" => "Acknowledgments" "texto" => "<p id="par0815" class="elsevierStylePara elsevierViewall">The GeSIDA (AIDS Study Group) Directorates are grateful for the support and opinions of Miguel Cervero, Carlos Folguera, José Antonio Iribarren, Ramón Morillo, Miguel Ángel Rodríguez-Sagrado, and Isabel Viciana, whose efforts have improved the writing and enriched the contents of the document.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/0213005X/0000003700000007/v1_201907280647/S0213005X18301678/v1_201907280647/en/main.assets" "Apartado" => array:4 [ "identificador" => "8681" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Documento de consenso" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000003700000007/v1_201907280647/S0213005X18301678/v1_201907280647/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X18301678?idApp=UINPBA00004N" ]
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Executive summary
Executive summary of the GeSIDA consensus document on control and monitoring of HIV-infected patients
Resumen ejecutivo del Documento de consenso de GeSIDA sobre el control y la monitorización de la infección por el VIH
AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology 1
Complexo Hospitalario Universitario/IIS Galicia Sur, Clara Campoamor, Pontevedra, Vigo, Spain