An annual offer of a full sexual health screen (regardless of reported history) and the outcome documented in the HIV case notes, including whether declined (IIb). Syphilis serology should be documented at baseline and performed yearly. In individuals or groups at increased risk of syphilis (MSM), syphilis serology E7080 cost should be considered with routine HIV follow-up (2–4 times yearly) (IIb). All women should have cervical smears

performed annually (IV). Screening for anal dysplasia by anal cytology may be beneficial; however, there is insufficient evidence at this time to support its routine introduction (IV). Gender-specific aspects of HIV monitoring will be discussed fully in the BHIVA women’s guidelines currently under

development. Approximately 20% of HIV-infected individuals accessing care in the UK are aged 50 years or more [1]. The prevalence of ageing HIV-infected Obeticholic Acid individuals continues to increase as a result of: (i) greater survival rates among HIV-infected patients; (ii) delayed recognition of the infection in older individuals; and (iii) continued new infections in older individuals. There is a need to adapt the management of HIV-infected individuals to ensure that the clinical needs of these individuals continue to be met as they age. However, very little is known about the likely healthcare needs of these patients. Existing reports on the clinical picture of HIV infection among older individuals are largely anecdotal; HIV may accelerate several

age-related conditions, and HIV-infected individuals may experience accelerated frailty, accelerated bone mineral loss and different levels of drug absorption and metabolism compared with their younger counterparts. Impaired glomerular function, impaired tubular function and proteinuria are all more common in the elderly. While this age-related decline in renal function is unlikely to result in severe kidney failure, it may affect many homeostatic processes, which may have implications for exacerbation of bone mineral loss and/or increased cardiovascular risk. The impact on adherence and potential drug–drug interactions of treatment for age-related comorbidities in patients who may be receiving ART has not been documented. HIV infection GPX6 and ageing are also both associated with changes in immunity and host defence. The potential for full immune restoration among older individuals receiving HAART for prolonged periods of time has not been fully investigated. In older individuals, drug pharmacokinetics (absorption, distribution, metabolism, and elimination) are altered [2] as a result of: (i) changes in gastric pH; (ii) body fat increase and water decrease; (iii) reductions in liver volume, blood flow and metabolic enzyme activity; (iv) decreased renal function.