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assess the neurological and mental status, paying attention to: symptoms of neuropathy, visual impairment, clarity of consciousness, adequacy of answers to questions, the presence of delusional ideas, the pace of mental processes (inhibition or acceleration), the presence of mood disorders (complaints of depression, apathy, indifference, fatigue, irritability), the presence of suicidal thoughts, impaired memory and attention, motor awkwardness. Laboratory diagnostic studies HIV testing should be voluntary and based on the following principles: 1. Informed consent of the patient; 2. Confidentiality; 3. HIV counseling, incl.

before and after the test; 4. Ensuring the reliability of test results and the timeliness of submission to the clinician; 5. Cooperation with services for the provision of medical, social and psychological assistance; 6. Anonymity at the request of the patient.

In order to establish a diagnosis of HIV infection, it is recommended to conduct a medical examination for the detection of HIV in full accordance with the algorithm presented in SP 3.1.5.2826-10 "Prevention of HIV infection", (see Chapters IV. Procedure for testing for HIV infection of sanitary and epidemiological rules approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated 11.01.2011 No. 1, as well as Appendix 2 informed consent form) [26-31] (2A). Comments: also in accordance with the order of the Ministry of Health of the Russian Federation of December 20, 2012 No.

1177n (as amended by the Order of the Ministry of Health of the Russian Federation of August 10, 2015 No. 549n), when applying for medical help to a medical organization providing medical care in a hospital, the patient signs general informed consent to medical interventions carried out in a medical institution, included in the List of certain types of medical interventions (determined by order of the Ministry of Health and Social Development of Russia dated April 23, 2012 No.

Paragraph 9 of this order approved laboratory methods of examination, including clinical, biochemical, bacteriological, virological, immunological.

In turn, according to the Order of the Ministry of Health of the Russian Federation of February 21, 2000 No. 64 "On Approval of the

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Nomenclature of Clinical Laboratory Tests", the nomenclature of clinical laboratory tests defines immunoserology (clause 9.2.3.) and microbiological methods for identifying viruses (clause 9.2. 4.), which allows for ELISA and PCR diagnostics of HIV infection when signing informed consent for medical intervention. The tasks of a laboratory examination when registering for a dispensary for HIV infection include: confirmation of the diagnosis of HIV infection; determination of the degree of immunosuppression (by absolute and percentage of CD4 and CD8); identification of indications for chemoprophylaxis of secondary diseases (according to the absolute and percentage of CD4); identification of vital indications for an urgent start of ART; identification of secondary diseases, determination of their severity and the need for treatment; identifying comorbidities, determining their severity and the need for treatment.

Nonspecific laboratory signs of HIV infection are: decrease in the number of lymphocytes, especially CD4; an increase in the number of CD8; inversion of the CD4 / CD8 ratio (decrease to less than 1); an increase in the number of immunoglobulins, mainly due to IgG; manifestations of cytopenic syndrome (anemia, leukopenia, thrombocytopenia).