Document 0363
 DOCN  M9460363
 TI    Preventive care among HIV-positive patients in a general medicine
       practice.
 DT    9408
 AU    Gifford AL; McPhee SJ; Fordham D; Robert Wood Johnson Clinical Scholar
       Program, Stanford University; School of Medicine, Palo Alto, California
       94304.
 SO    Am J Prev Med. 1994 Jan-Feb;10(1):5-9. Unique Identifier : AIDSLINE
       MED/94226831
 AB    We randomly selected a cohort of human immunodeficiency virus
       (HIV)-positive patients from a large university-based general medicine
       practice to determine how often recommended disease prevention services
       are received. We used a standardized medical record review protocol to
       gather data from the records of 159 randomly selected HIV-positive
       adults followed in a university general medicine practice. We set 80% as
       the minimum acceptable rate of receipt of each recommended preventive
       service. Within three months of initiating HIV care, 88% of patients had
       CD4+ cell counts. Within six months, 75% had serology for syphilis, 64%
       had purified protein derivative tuberculin skin tests, 64% had hepatitis
       B serology, and 49% had pneumococcal vaccinations. Within one year, 33%
       had influenza vaccinations. Of 50 subjects eligible for Pneumocystis
       carinii prophylaxis (CD4+ cells < 200/mm3), 88% had started prophylaxis
       within six months. Of 56 subjects eligible for antiretroviral therapy
       (CD4+ cells < 500/mm3), 77% had started an antiretroviral within six
       months. Within one year, 22% of 23 subjects with documented nonimmunity
       to hepatitis B began hepatitis vaccination; only one subject completed
       the series of three vaccinations. Many HIV-positive patients did not
       receive appropriate screening tests for tuberculosis and syphilis or
       vaccinations for pneumococcal pneumonia, influenza, and hepatitis B.
       Patients did receive CD4+ cell counts, Pneumocystis carinii prophylaxis,
       and antiretroviral therapy at acceptable rates.
 DE    Adult  Antiviral Agents/*THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*PREVENTION & CONTROL  Cohort Studies  *Family Practice
       Female  Homosexuality  Human  *HIV Seropositivity/DIAGNOSIS/DRUG THERAPY
       Leukocyte Count  Male  Middle Age  Pneumonia, Pneumocystis
       carinii/PREVENTION & CONTROL  Practice Guidelines  *Preventive Health
       Services  Risk Factors  Support, Non-U.S. Gov't  T4 Lymphocytes  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).