Transfer of HIV Care – What Do You Need to Consider?
**No Longer Available for Credit**

   

Deborah, a 31-year-old female, has recently moved to your area and she schedules an appointment to establish care.  She has no additional medical history.  She takes a multivitamin daily.  She was diagnosed with HIV at her OB/GYN’s office 10 years ago by routine screening.  She was started on coformulated emtricitabine/tenofovir disoproxil fumarate/efavirenz (Sustiva) at that time by her HIV provider and she has been on it since her diagnosis and she has no tolerability issues. She is currently asymptomatic.

Data:

  • BP: 120/70 mmHg
  • CD4 count: 700 cells/mm3
  • HIV RNA by PCR: <20 copies/mL
  • Hepatitis A and B: immune
  • Hepatitis C antibody: negative

Questions for Discussion:

  1. What additional information would be important for you to know about Deborah as she transfers into your care?
  2. Would you recommend updating Deborah’s antiretroviral therapy to an integrase inhibitor based regimen?  Why or why not?
  3. At what point do you approach changing a patient’s regimen who is new to your practice and you are still developing a trusting relationship?