Academy Exchange

I work for an FQHC and have been asked to give a talk to our primary care providers about when to test for HIV, outside the normal screening guidelines (which as you all know are a pretty low bar). Basically, clinical findings that might indicate an advanced HIV infection outside the classic "AIDS defining illness". I'm thinking about some of the things I've seen in newly diagnosed patients over the years that might show up in a PCP's exam room - like molluscum on the face, severe tinea pedis, severe seborrhea, thrush. I've got a list of about a dozen things, but wanted to ask if any of you had input. What have you seen in your practice that might have resulted in an earlier diagnosis if the PCP had seen it and thought to test for HIV? 

Deb,

To your list I would add shingles, severe or recurrent vaginal candidiasis, bacterial pneumonia, severe or recurrent herpes, thrombocytopenia, lymphopenia, elevated total protein, diffuse lymphadenopathy, oral hairy leukoplakia, seborrheic dermatitis (doesn't have to be severe), persistent diarrhea, oral or genital ulcers, new onset depression, mania, or dementia, and of course any sexually transmitted infection. 

And let's not forget that PCPs are supposed to be checking for HIV in all their patients, not just those with symptoms.

I work for an FQHC and have been asked to give a talk to our primary care providers about when to test for HIV, outside the normal screening guidelines (which as you all know are a pretty low bar). Basically, clinical findings that might indicate an advanced HIV infection outside the classic "AIDS defining illness". I'm thinking about some of the things I've seen in newly diagnosed patients over the years that might show up in a PCP's exam room - like molluscum on the face, severe tinea pedis, severe seborrhea, thrush. I've got a list of about a dozen things, but wanted to ask if any of you had input. What have you seen in your practice that might have resulted in an earlier diagnosis if the PCP had seen it and thought to test for HIV? 

Deb,

To your list I would add shingles, severe or recurrent vaginal candidiasis, bacterial pneumonia, severe or recurrent herpes, thrombocytopenia, lymphopenia, elevated total protein, diffuse lymphadenopathy, oral hairy leukoplakia, seborrheic dermatitis (doesn't have to be severe), persistent diarrhea, oral or genital ulcers, new onset depression, mania, or dementia, and of course any sexually transmitted infection. 

And let's not forget that PCPs are supposed to be checking for HIV in all their patients, not just those with symptoms.

I work for an FQHC and have been asked to give a talk to our primary care providers about when to test for HIV, outside the normal screening guidelines (which as you all know are a pretty low bar). Basically, clinical findings that might indicate an advanced HIV infection outside the classic "AIDS defining illness". I'm thinking about some of the things I've seen in newly diagnosed patients over the years that might show up in a PCP's exam room - like molluscum on the face, severe tinea pedis, severe seborrhea, thrush. I've got a list of about a dozen things, but wanted to ask if any of you had input. What have you seen in your practice that might have resulted in an earlier diagnosis if the PCP had seen it and thought to test for HIV? 

I work for an FQHC and have been asked to give a talk to our primary care providers about when to test for HIV, outside the normal screening guidelines (which as you all know are a pretty low bar). Basically, clinical findings that might indicate an advanced HIV infection outside the classic "AIDS defining illness". I'm thinking about some of the things I've seen in newly diagnosed patients over the years that might show up in a PCP's exam room - like molluscum on the face, severe tinea pedis, severe seborrhea, thrush. I've got a list of about a dozen things, but wanted to ask if any of you had input. What have you seen in your practice that might have resulted in an earlier diagnosis if the PCP had seen it and thought to test for HIV? 

I work for an FQHC and have been asked to give a talk to our primary care providers about when to test for HIV, outside the normal screening guidelines (which as you all know are a pretty low bar). Basically, clinical findings that might indicate an advanced HIV infection outside the classic "AIDS defining illness". I'm thinking about some of the things I've seen in newly diagnosed patients over the years that might show up in a PCP's exam room - like molluscum on the face, severe tinea pedis, severe seborrhea, thrush. I've got a list of about a dozen things, but wanted to ask if any of you had input. What have you seen in your practice that might have resulted in an earlier diagnosis if the PCP had seen it and thought to test for HIV?