As evidence is not consistent [14],

serological HSV testi

As evidence is not consistent [14],

serological HSV testing of HIV-positive pregnant women is not routinely recommended (IV). Serological HSV testing of pregnant women with no history of genital herpes is indicated when there is a history of genital herpes in the partner Buparlisib (IIb) [15-17]. HSV-1- and/or HSV-2-seronegative women should be counselled about strategies to prevent a new infection with either virus type during pregnancy. The reader is referred to the BHIVA immunization guidelines [1] for a detailed description of the indications and modalities for screening and vaccination. Screening for measles IgG is currently recommended in all patients at the time of diagnosis, to identify seronegative patients and offer them vaccination if appropriate [1]. Testing of rubella antibody is recommended in women of child-bearing age to guide vaccination. Depending on the local clinic arrangements, selective screening of women may not be practical and testing of all HIV-positive persons may

be preferred. Pregnant women will be screened for rubella as part of their antenatal tests. Post-vaccination testing is not routinely recommended. In the pre-HAART era, CMV was one of the commonest opportunistic infections in HIV-positive patients, with the risk of disease increasing as the CD4 T-cell count fell. With seropositive rates being in excess of 90% in HIV-positive patients, baseline screening was performed to identify seronegative patients who would benefit from screened blood products if required. Now, CMV disease is much less common, and blood when required is leucodepleted. mafosfamide In addition, molecular techniques have improved the diagnosis of CMV disease, and Smad inhibition a benefit of primary antiviral prophylaxis in reducing the risk of CMV disease has not been demonstrated in HIV-infected patients [18, 19]. Thus, there is little benefit from routine screening for CMV IgG. Testing for CMV IgG is therefore not routinely recommended (IV), but can be undertaken at the

time CMV disease is suspected. Recommendations regarding TB screening are taken directly from the BHIVA 2011 TB guidelines [1]. The sensitivity and utility of tuberculin skin testing (TST) in HIV infection is markedly diminished [2-4] and specificity may also be compromised by bacille Calmette–Guérin (BCG) vaccination. Sensitivity may be improved by combining TST with interferon gamma release assays; however, there are presently insufficient data to recommend this [5]. As elaborated in the BHIVA tuberculosis guidelines [1], routine TST in HIV-positive patients is not recommended for either diagnosis or screening (IIa). Assays that detect interferon-gamma release from T cells stimulated with TB-specific antigens have been shown to be more sensitive and specific than TST in HIV-seronegative individuals with latent and active tuberculosis. There are increasing data becoming available in HIV-infected individuals [6, 7]. The following are the recommendations of the BHIVA TB guidelines [1] regarding screening.

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