Transfer of HIV Care – What Do You Need to Consider?
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.
- 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:
- What additional information would be important for you to know about Deborah as she transfers into your care?
- Would you recommend updating Deborah’s antiretroviral therapy to an integrase inhibitor based regimen? Why or why not?
- 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?