Selected Themes from the HIV-related Clinical Screening Session

A report on the Screening symposium session on day 2 of the Conference.

This session tackled common HIV associated medical conditions that we should all be thinking about regularly, the management of which I am sure we could all improve in our daily practices.

Mark Boyd highlighted findings of the prospective D.A.D observational study, pointing out that it is worth doing regular CKD and CVD risk profiles in tandem using the D.A.D. online calculator which outperforms the Framingham for HIV, and of course addressing risk factors such as smoking especially for those scoring high in both CVD and CKD risks.

Richard Hillman reminded us that anal cancer has a terrible survival rate of 65% at 5 years, for what should be a curable cancer if picked up early, but if you don’t look you won’t find it. Anal cancer is the third most common cancer for HIV positive men, particularly those with lower CD4 counts.

Since we no longer do PR exams for prostate cancer screening in general practice it seems easy to put this examination off for another day, when really it could be life saving for our patients. This is something that I really need to improve.

 A. Prof Brotherton talked about CST screening in HIV positive women, evidence is not available yet to stratify women into low risk categories as the research into this is lacking, hence the continued recommendation to screen as for immune suppression even at high CD4. She pointed out that CST self collection should be offered to those who are under or never screened. The good news is that the new CST promises to reduce rates of cervical cancer overall compared to PAP smears.

This was definitely a worthwhile session, many presenters have pointed out that HIV management has become the easy part of managing patients and that the bread and butter of GPs that is screening and managing risk factors is becoming ever more important.

Author bio:

Janet is a GP working in Darlinghurst with a special interest in HIV, sexual health womens health and paediatrics.