Table 5.
MEDICAL MANAGEMENT OF CHILDREN WITH HIV INFECTION
| Evaluation | Interval |
|---|---|
| Complete history and physical examination | 3 mo |
| Review of systems | 3 mo |
| Immunization | See Table 7 |
| Developmental examination | |
| 0–12 mo | 3 mo |
| 1–3 y | 6 mo |
| > 3 y | Annually |
| CT scan of the brain | Baseline and as indicated |
| Chest radiography | Annually |
| Laboratory values | |
| Complete blood count | 3 mo |
| T-cell subsets | 3 mo |
| HIV RNA PCR (quantitative) | 3 mo |
| Liver enzymes | 3 mo |
| Pancreatic enzymes | 3 mo |
| Electrolytes, BUN, and creatinine | Baseline and as indicated |
| Quantitative immunoglobulins | 6 mo |
| Urine analysis | Annually |
| Serology | |
| Cytomegalovirus | Baseline, annually if negative |
| Epstein-Barr virus | Baseline, annually if negative |
| Toxoplasmosis | Baseline, annually if negative |
| Rubella | Baseline |
| Varicella-zoster | Baseline |
| Herpes simplex | Baseline |
| Hepatitis B, C | Baseline |
| Tuberculin skin test and control | Annually* |
| Referrals | |
| Ophthalmologic examination | Annually† |
| Dental examination | 6 mo |
| Cardiology (echocardiogram) | If clinically indicated |
| Gynecologic examination | Puberty, annually thereafter |
| PCR = polymerase chain reaction, BUN = blood urea nitrogen. | |
*
For control use mumps or tetanus antigen if the patient has already been immunized; otherwise use candida antigen.
†
Every 6 mo if severely immunosuppressed.