Approach to previously established HIV positive Pt

• H&P (mucocutaneous, neurocognitive, OIs, malignancies, STDs); meds and adherence
• Review ARVs (past and current); if hospitalized typically continue ARVs, if any must be held, stop all to ↓ risk of resistance
• Regimen failure: cannot achieve undetectable VL after months on ARVs, viral rebound (VL >200 copies/mL ×2 after prior suppression), ↓ CD4 count or clinical worsening