Résumé

• The aim of initial assessment is to establish the prognosis and the need for highly active antiretroviral therapy (HAART).
• Diagnosis and management varies between resource-intensive settings and resource-limited settings.
• Patients should be clinically staged according to WHO or Centers for Disease Control and Prevention (CDC) criteria.
• All patients should have a CD4 count, hepatitis B and C screen, VDRL, tuberculin skin test, and CXR. HIV viral load is also assessed at baseline in most developed countries. Drug resistance testing (genotype/phenotype) is recommended in settings with high levels of circulating resistant virus.
• TB and Pneumocystis jirovecii pneumonia prophylaxis and immunisation with pneumococcal, influenza, hepatitis B and A, and tetanus vaccines should be considered.
• The decision to initiate HAART depends on the patient's clinical stage, CD4 count, medical comorbidities, and ability to adhere to chronic HIV treatment.