We reviewed prominent national and international guidelines to compare recommendations for laboratory monitoring for persons on antiretroviral therapy. The United States Department of Health and Human Services guidelines recommend more frequent CD4 count, viral load, hematologic, renal, and liver tests than other guidelines. To evaluate the evidence base for these recommendations, we reviewed phase 3 trials of currently recommended antiretroviral regimens and large cohort studies. Cohort studies have consistently shown that persons with sustained viral suppression have stable or increasing CD cell counts, so it is not clear how continued CD4 count monitoring contributes to clinical care. Long-term safety data from trials and observational cohorts show little evidence to support hematologic, hepatic, or renal monitoring (apart from persons on tenofovir disoproxil fumarate). It is time to use the available data from clinical trials and cohort studies to develop evidence-based recommendations for laboratory monitoring tests for persons with viral suppression.

中文翻译：

---

针对接受抗逆转录病毒治疗的青少年和成人实验室监测的循证建议


我们回顾了著名的国家和国际指南，以比较对抗逆转录病毒治疗者进行实验室监测的建议。美国卫生与公众服务部指南建议比其他指南更频繁地进行 CD4 计数、病毒载量、血液学、肾脏和肝脏检测。为了评估这些建议的证据基础，我们回顾了目前推荐的抗逆转录病毒方案的 3 期试验和大型队列研究。队列研究一致表明，持续病毒抑制患者的 CD 细胞计数稳定或增加，因此尚不清楚持续 CD4 计数监测如何有助于临床护理。来自试验和观察队列的长期安全性数据显示，几乎没有证据支持血液学、肝脏或肾脏监测（服用富马酸替诺福韦二吡呋酯的人除外）。现在是时候利用临床试验和队列研究的可用数据，为病毒抑制患者的实验室监测测试制定循证建议了。