Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

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1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Follow-Up Evaluation
     
     There have been no controlled studies to serve as the basis
for recommending specific follow-up tests or follow-up intervals.
The suggested frequency of monitoring is based on the slow decrease
in CD4+ counts observed among patients in cohort studies, but
should be modified depending on the patient's psychological status,
the presence of symptoms, or both. Repeat evaluation for STDs also
is important in the follow-up of HIV-infected persons and should be
performed on all persons who continue to be sexually active.
Follow-up evaluation should be performed every 6 months and should
include the following:

--   An interim history and physical examination;

--   A complete blood count, platelet count, and lymphocyte subset
     analysis;

--   Re-evaluation of psychosocial status and behavioral factors
     indicating risk for transmitting HIV.

     To follow CD4+ measurements, providers should use the same
laboratory and, optimally, obtain each specimen at the same time
each day. When unexpected or discrepant results are obtained or
when major treatment decisions are to be made, health-care
providers should consider repeating the CD4+ measurement after at
least 1 week.

     More frequent laboratory monitoring, every 3-4 months, is
indicated if CD4+ results indicate a patient is close to a point
when a clinical intervention may be indicated.

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