HIV

Fasting laboratory tests

• HIV serology (ELISA test and confirmation by Western blot with HIV-1/2 differentiation)
• CD4/CD8 T lymphocyte subset count
• Plasma HIV RNA (HIV viral load)
• HIV genotypic resistance test (reverse transcriptase, protease, integrase) and HIV-1 subtype determination
• HLA-B*5701 allele testing
• FBC
• AST
• ALT
• GGT
• Serum creatinine and eGFR by the CKD-EPI method
• Fasting plasma glucose
• Lipid profile
• Hepatitis B serology (HBsAg, anti-HBs and anti-HBc antibodies)
• Hepatitis C serology
• Hepatitis A serology (IgG)
• Syphilis serology
• Toxoplasmosis serologyif neededCD4 lymphocytes < 200/µL.
• IGRA test (Quantiferon or T-SPOT.TB) for screening for latent tuberculosisif neededPerson from a tuberculosis-endemic area and/or in social deprivation (repeat once CD4 exceed 200/µL).
• Cryptococcal antigenif neededCD4 lymphocytes < 100/µL.
• CMV serologyif neededCD4 lymphocytes < 100/µL (if positive: CMV PCR and fundoscopy).
• Serum β-hCGif neededWoman of childbearing potential.
• Varicella serologyif needednon-French guidelineRecommended in the initial assessment in the United Kingdom (BHIVA 2016, grade 1B) to decide on vaccination, unless there is a reliable history of infection or vaccination ^[2]. The 2024 French recommendation does not include them in the initial assessment; the history records the vaccinations received ^[3].
• Measles serologyif needednon-French guidelineRecommended in the initial assessment in the United Kingdom (BHIVA 2016, grade 1B) to decide on vaccination, unless there is a reliable history of infection or vaccination ^[2]. The 2024 French recommendation does not include them in the initial assessment; the history records the vaccinations received ^[3].
• Rubella serology (if woman of childbearing potential without documented vaccination)if needednon-French guidelineRecommended in the initial assessment of women of childbearing potential in the United Kingdom (BHIVA 2016, grade 1B) to decide on vaccination, unless there is a reliable history of infection or vaccination ^[2]. The 2024 French recommendation does not include it in this assessment ^[3].

Urine tests

• Urine protein:creatinine ratio (spot sample)
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR)

Laboratory tests

• Syphilis serology
• Hepatitis C serology
• Hepatitis B serology (if not vaccinated or non-responder)if neededIf not vaccinated or non-responder.
• Chlamydia trachomatis, Neisseria gonorrhoeae NAAT (PCR)if neededMultiple or high-risk sexual partners: depending on the context and practices (anal, urethral, pharyngeal sites).
• To be repeated every 3 to 6 months

Laboratory tests

• Plasma HIV RNA
• Serum creatinine with eGFR by CKD-EPI (if tenofovir)if neededTenofovir disoproxil (TDF) or other nephrotoxic treatment, or comorbidity.
• Fasting serum phosphateif neededTreatment with tenofovir disoproxil: 2 to 4 weeks after initiation, then every 3 to 6 months if there is no renal risk.
• Glycosuriaif neededTreatment with tenofovir disoproxil: 2 to 4 weeks after initiation, then every 3 to 6 months if there is no renal risk.
• ASTif neededHepatotoxic treatment, exposure to hepatitis viruses (STIs, slamming), excessive alcohol consumption, overweight or diabetes.
• ALTif neededHepatotoxic treatment, exposure to hepatitis viruses (STIs, slamming), excessive alcohol consumption, overweight or diabetes.
• GGTif neededHepatotoxic treatment, exposure to hepatitis viruses (STIs, slamming), excessive alcohol consumption, overweight or diabetes.
• Hepatitis B serologyif neededNo seroprotection against HBV with ongoing risk exposure (every 6 to 12 months); check anti-HBs after vaccination.
• Hepatitis C serologyif neededHigh-risk sexual exposure or signs of STI (HCV RNA if a previous serology was positive); multiple partners: every 3 to 6 months.
• Syphilis serologyif neededMultiple sexual partners: every 3 to 6 months.
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR) (PCR at anal, urethral and/or pharyngeal level)if neededMultiple or high-risk sexual partners: depending on the context and practices (anal, urethral, pharyngeal sites).
• CD4/CD8 T lymphocyte subset count (if CD4 < 200/µL)if neededCD4 lymphocytes < 200/µL.
• cryptococcal antigen assay (if CD4+ < 100/mm3)if neededIf CD4+ < 100/mm3.
• CMV PCR (if CMV serology positive)if neededCD4 < 100/µL and positive CMV serology (if PCR positive: fundoscopy).

Laboratory tests

• FBC and CD4 and CD8 lymphocyte subset count (every two years if HIV RNA < 50 copies/mL over the period and latest CD4 > 500/mm3)
• Plasma HIV RNA
• AST
• ALT
• GGT
• Serum creatinine with eGFR by the CKD-EPI method
• Serum phosphate (if taking tenofovir)if neededTenofovir disoproxil (TDF).
• Plasma glucose (from 45 years, to be repeated every 3 to 5 years if initially normal)if neededFrom 45 years of age, every 3 to 5 years if normal, or according to the indications of the lipid profile.
• Lipid profileif needed6 months after starting or changing an antiretroviral; weight gain, lipohypertrophy, BMI > 30, new risk factor, cardiovascular event, early family history; 1 to 3 months after lipid-lowering treatment; otherwise every 5 years.
• Syphilis serologyif neededMultiple sexual partners: every 3 to 6 months.
• Hepatitis C serology (or HCV PCR if cured of hepatitis C)if neededHigh-risk exposure (HCV RNA if a previous serology was positive, in particular after cure of hepatitis C).
• Hepatitis B serology (HBsAg, anti-HBs antibodies, anti-HBc antibodies)if neededNo seroprotection against HBV with ongoing risk exposure (every 6 to 12 months); check anti-HBs after vaccination.
• Chlamydia trachomatis, Neisseria gonorrhoeae NAAT (PCR) (at anal, urethral and pharyngeal level)if neededMultiple or high-risk sexual partners: depending on the context and practices (anal, urethral, pharyngeal sites).
• Serum albumin (from 70 years)if neededFrom 70 years of age, every 2 to 5 years, during the geriatric assessment.
• Cryptococcal antigen (if CD4 < 100/µL)if neededCD4 lymphocytes < 100/µL.
• CMV serology (if CD4 < 100/µL and previous serology negative)if neededCD4 < 100/µL with a previously negative CMV serology (if positive: CMV PCR, then fundoscopy if PCR positive).
• 25-hydroxyvitamin D (with bone densitometry)if neededOsteoporosis screening: postmenopausal woman, man over 60 or risk factor.

Urine tests

• Urine albumin:creatinine ratio (spot sample)
• Urine protein:creatinine ratio (spot sample) (if tenofovir disoproxil)if neededTenofovir disoproxil (TDF).