Good afternoon,
I had to review the guidelines again myself. I will say that the summary table on page 15 is confusing. But in reading the rest of the guidelines and recommendation, I understand the recommendation to check an HIV PCR ( as suggested by the algorithm diagram) is in instances where there is a reported or potential exposure to HIV and there is concern for acute HIV infection. As the two figures 4a and 4b are under the header of ACUTE HIV INFECTION. So I understand it to say that IF you have a person on PrEP currently and there is a history suggestive of ACUTE HIV INFECTION, then you should proceed with an Ag/Ab test AND a PCR.
I await clarification from the Guideline Committe. I am sure Dawn Smith, would welcome the commentary
------------------------------
Quintin Robinson
Absolute Care Medical Center & Pharmacy
Atlanta GA
------------------------------
Original Message:
Sent: 01-05-2022 16:47
From: Joshua Rohr
Subject: recently updated CDC PrEP guidelines, point of clarification
I'm curious what providers are doing about the somewhat confusing new PrEP guidelines update from last month.
For patients who have taken ART in the past 90 days as PEP or PrEP, we now would run both an HIV screen AND a viral load every 3 months? I think I see what they're trying to catch here but the lab and cost burden are taking me by surprise. I found it odd this significant change wasn't called out in the "What's New" intro.
PrEP Guideline 2021 Update (cdc.gov) pages 15, 30 and 31 are what I'm referring to.
Any other takes or insights?
Thanks in advance,
Josh Rohr PA-C
------------------------------
Joshua Rohr
Seattle WA
------------------------------