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as AZT, and in those with marginal or low counts.
Serum Chemistry Panel: This panel is advocated in the initial evaluation of HIV infection due to high rates of baseline hepatic disease (J Infect Dis 2002;186:231),to assess renal function and nutritional status, and to obtain baseline values in patients who are likely to have multisystem disease due to HIV or its treatment. Up to 75% of HIVinfected patients have abnormal transaminases at baseline and 20% have severe abnormalities (JAIDS 1994;7:1134).
Syphilis Serology (MMWR 2006;55[RR-1]:22): Screen with a nontreponemal test (VDRL or RPR) at baseline and annually thereafter in sexually active patients due to high rates of co-infection. Up to 6% of patients with HIV infection have biologic false-positive (BFP) screening tests. Some labs now screen with treponema EIA tests which detects persons with untreated or incompletely treated syphilis (Infect Med 2004;21:399). False positives may occur so confirmatory tests are necessary. With RPR or VDRL, risk factors for biologic falsepositive results include injection drug use, pregnancy, and HIV infection (CID 1994;19:1040; JID 1992;165:1124; JAIDS 1994;7:1134; Am J Med 1995;99:55). In one review of 300,000 VDRLs, the rate of biologic false positives was 2.1% in persons with HIV compared to 0.24% in those
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TABLE 2-16: