Yield of yearly routine physical examination in HIV-1 infected patients is limited:A retrospective cohort study in the Netherlands

Background Routine physical examinations might be of value in HIV-infected patients, but the yield is unknown. We determined the diagnoses that would have been missed without performing annual routine physical examinations in HIV-infected patients with stable disease. Methods Data were collected from the medical records of 299 HIV-1-infected patients with CD4 count >350 cells/mm(3) if not using combination antiretroviral therapy (cART), or CD4 count >100 cells/mm3 and undetectable viral load if using cART. We defined the diagnoses that would have been missed without performing routine ph... Mehr ...

Verfasser: van Amsterdam, Marleen A.
van Assen, Sander
Sprenger, Herman G.
Wilting, Kasper R.
Stienstra, Ymkje
Bierman, Wouter F. W.
Dokumenttyp: Artikel
Erscheinungsdatum: 2017
Reihe/Periodikum: van Amsterdam , M A , van Assen , S , Sprenger , H G , Wilting , K R , Stienstra , Y & Bierman , W F W 2017 , ' Yield of yearly routine physical examination in HIV-1 infected patients is limited : A retrospective cohort study in the Netherlands ' , PLoS ONE , vol. 12 , no. 6 , e0179539 . https://doi.org/10.1371/journal.pone.0179539
Schlagwörter: HIV-INFECTED PATIENTS / INVASIVE ANAL CANCER / ANTIRETROVIRAL THERAPY / SKIN-CANCER / MEN / MALIGNANCIES / MORBIDITY / DISEASE / UPDATE / SEX
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27602443
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/f1c63882-97f1-41f0-b92d-7d4f1b8e4fb5

Background Routine physical examinations might be of value in HIV-infected patients, but the yield is unknown. We determined the diagnoses that would have been missed without performing annual routine physical examinations in HIV-infected patients with stable disease. Methods Data were collected from the medical records of 299 HIV-1-infected patients with CD4 count >350 cells/mm(3) if not using combination antiretroviral therapy (cART), or CD4 count >100 cells/mm3 and undetectable viral load if using cART. We defined the diagnoses that would have been missed without performing routine physical examinations on annual check-ups in 2010. Exclusion criteria were hepatitis B/C co-infection, start/switch of cART Results 215 patients (72%) had positive findings: lipodystrophy (30%), lymphadenopathy (16%) and hypertension (8.4%) were the most common. Two-thirds of all findings were not new or were based on complaints indicating a physical examination even if not routinely scheduled. For 24 patients (8.0%) the routine physical examination led to the finding of a new diagnosis: six-all men who have sex with men (MSM)-had a concurrent sexually transmitted infection, eight had hypertension, and ten others had a large variety of diagnoses. A total atrioventricular block with bradycardia was the most clinically relevant finding. Conclusions Annual physical examinations of HIV-infected patients with stable disease brought few new diagnoses that would have been missed without performing a routine examination. Our results suggest that standard assessments could be restricted to six-monthly measuring blood pressure in all patients and annually performing anogenital and digital rectal examination on MSM.