Base line investigations for an infant / child known to have HIV and about to start on ART

Submitted by Paul Decle on Fri, 05/08/2011

Authors: Guide information
Hermione Lyall

Date of preparation:June 2003
Date reviewed: February 2011
Next review date: February 2012

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These investigations should be carried out at baseline before starting antiretrovrials, and then repeated at least 3-4 monthly. In the early weeks after starting when toxicities are most likely to arise, the biochemistry and haematology investigations should be undertaken at weeks 2, 4, 8, 12.

HIV parameters

HIV RNA PCR
CD4 count
(Resistance and HLA B5701 if not already done)
Haematology FBC (differential WBC)
Biochemistry U+E, Creat
Ca, PO4
LFT's
Glucose
Vitamin D/PTH if not recently done

Total Protein (Globulin)
Albumin
Lipids
Amylase

Clinical Investigations BP
Urinalysis
Height / Weight / Head circumference (<5yrs old)
Baseline developmental assessment
Annually consider TSH
Vitamin D/PTH
Immunisation responses
Repeat Hepatitis A, B, C status (if negative at baseline)
Repeat herpes virus serology for those sero-negative at baseline
Growth and bone age
Pubertal staging assessment
Lipodystrophy assessment
Developmental assessment
Social situation and Adherence To be reviewed before start of treatment and as necessary – see adherence guidelines