Clinical recommendation	Evidence rating	References
Routine HIV screening should be considered for patients 13 to 64 years of age and for pregnant women, particularly if the prevalence of undiagnosed infection in the physician's patient population is documented to be 0.1 percent or more.	C	11
Patients with HIV infection who have a CD4 cell count of less than 350 cells per mm3 (350 × 109 per L) should undergo genotypic or phenotypic resistance testing before appropriate antiretroviral pharmacotherapy is selected.	B	15
Initial antiretroviral regimens for HIV infection should include a combination of three agents, typically two nucleoside reverse transcriptase inhibitors, plus one nonnucleoside reverse transcriptase inhibitor or one protease inhibitor. The primary goal of antiretroviral therapy should be achieving an undetectable viral load (plasma HIV RNA of less than 48 copies per mL).	A	1, 4, 14, 15
CD4 cell count thresholds should be used to determine the need for antimicrobial prophylaxis against opportunistic infections in patients with HIV infection. Patients with CD4 cell counts of less than 200 cells per mm3 (200 × 109 per L) require prophylaxis.	B	4
Primary care for patients with newly diagnosed HIV infection should include screening for opportunistic diseases and sexually transmitted infections. Annual tuberculin testing also should be performed, and vaccination histories should be updated at each office visit.	C	1, 4, 15, 21