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M9460363.TXT
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1994-06-12
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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).