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recommended that all patients undergo a set of laboratory diagnostic tests to identify the following diseases when they are registered with the dispensary (see the relevant clinical guidelines) [16, 17, 37, 249-253] (2B): syphilis (see the relevant clinical guidelines); viral hepatitis C (see relevant clinical guidelines); viral hepatitis B (see relevant clinical guidelines); toxoplasmosis (Toxoplasma gondii) (see relevant clinical guidelines); cytomegalovirus (Cytomegalovirus) (see relevant clinical guidelines); tuberculosis (see relevant clinical guidelines). It is recommended that all patients undergo a diagnosis of chronic kidney disease upon admission to the dispensary (see the relevant clinical guidelines): a study of nephron function by creatinine clearance (including Reberg's test) (see the relevant clinical guidelines).
It is recommended that for the purpose of screening for cervical cancer, all patients should be performed at dispensary registration [43,44,45,46,47] (2A) cytological examination of a micropreparation of the cervical canal; molecular biological study of discharge from the cervical canal for the human papillomavirus (Papilloma virus). It is recommended in patients with kidney disease to additionally perform [48,49,50] (2A): study of the level of total calcium in the blood; determination of phosphates in the blood. Comments: it is advisable to conduct these studies in patients from risk groups (persons over 65 years of age, persons with hyperparathyroidism, malabsorption syndrome, tuberculosis, diabetes mellitus, history of fractures, taking efavirenz**, GFR less than 60 ml/min, BMI more than 30, CRF , CKD stage 4).
Recommended if a patient has a CD4 count 500 µl -1 ; moderate immunodeficiency: CD4 350 - 499 µl -1 ; severe immunodeficiency: CD4 200 - 349 µl -1 ; severe immunodeficiency: CD4 100 µl -1 [210] (4C); obstetrician-gynecologist - at stage 3 according to the Republic of Kazakhstan, 2006 and CD4 ? 200 µl -1 - every 12 months; in all other cases, every 6 months [211] (4C); neurologist - every 6 months with CD4 200 µl- 1 [212] (4C); a phthisiatrician for CD4 100,000 copies/ml at a gestational age of less than 13 weeks [94,95,96] (1A). Comments: When an HIV-infected pregnant woman of 28 weeks' gestation or more is admitted, ART should be started no later than 3 days, regardless of indications and VL.
Prompt initiation of ART (no later than 2 weeks) is recommended for physicians responsible for the care of HIV-infected patients if: RK clinical stages 2, 4 and 5 [97] (2A) with Buy Detrol (Tolterodine) 2mg, 1mg online - General health CD4 count 100,000 copies/mL [97] (2A); chronic viral hepatitis B requiring treatment [3,4,37,98] (2B); diseases requiring prolonged use of immunosuppressive therapy, neurological diseases [3,4,37,99] (5C); need for assisted reproductive technology [100] (5C) partner without HIV infection in resistant serodiscordant couples [101] (2A) Comments: In patients over 50 years of age, initiation of ART may be considered as a priority due to the risk of more rapid disease progression.