Background BHIVA published guidelines in 2008 on the treatment of HIV infected adults. These guidelines were used as a basis for optimal patient care.
Aims To audit the following against BHIVA guidelines: (1) Initial investigations, assessment and monitoring after diagnosis (2) Choice of first line ARV regimen (3) Attainment of target HIV viral load <50 by 6 months of treatment (4) G.P. involvement in patient care.
Methods The medical records of 24 HIV positive patients, who were diagnosed and started on ARV medication during the preceding 12 months, were reviewed.
Results Initial investigations and assessment were done in all patients (100%), with the exception of cardiovascular risk assessment which was documented in only 20% of patients. 18/24 patients (75%) were started on the first line regimen recommended [2NRTI and 1 NNRTI], out of which 14 patients (58.3%) were started on Atripla. 5 patients (20.8%) received [2NRTI and boosted PI] and one patient was on [2NRTI and integrase inhibitor]. 20 patients (83.3%) achieved the target VL<50 within 6 months of treatment. In 3/24 (12.5%) patients the viral load was still detectable at 6 months. One patient moved away from the region. The G.P. was informed about the HIV positive status in only 62.5% patients.
Conclusion Several areas of clinical practice were identified for improvement and the following actions recommended: the use of a web-based virtual clinic resource which includes links to CVS risk calculators; proactive discussion with patients regarding the importance of disclosure of HIV status to their GP for safe and efficient care.
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