The Annual Checkup

Yearly physical exams for HIV-positive adults do not differ much from those performed on HIV-negative patients, says Michael Allerton, HIV operations policy leader for Northern California's Kaiser Permanente Medical Care Program. However, there are a few particular tests HIV caregivers will give their patients at least once per year. ' Tuberculosis test. TB, a potentially life-threatening lung disease, is more common and more severe in HIV-positive adults, says Judith Feinberg, MD, board chair of the American Academy of HIV Medicine. 'We prefer to provide preventive therapy than have [HIV-positive patients] develop clinical TB, which is a nasty disease.' ' Eye exam. To screen for cytomegalovirus infection, an AIDS-defining disease that can result in permanent eye damage or blindness, says Roxanne Cox-Iyamu, MD, medical director for the northern Virginia office of the Whitman-Walker Clinic. ' Skin exam. To check for any visible changes in moles and for other signs of skin diseases or skin cancer. Some doctors check more regularly because skin infections are common among HIV-positive adults, notes Feinberg. ' Mouth exam. To check for signs of infections like thrush and other oral complications of HIV disease, Feinberg says. As with skin problems, some doctors conduct mouth exams more regularly because oral infections are common among HIV-positive adults. ' Syphilis and other screenings. Some physicians recommend checking sexually active patients in high-risk groups as often as every six months, based on reported risk factors, says Tom Barrett, MD, a staff physician at Chicago's Howard Brown Health Center. Syphilis and other sexually transmitted diseases can make it more likely for an HIV-positive person to expose sex partners to the virus. The neurological symptoms associated with long-term syphilis infection also may be worse in people coinfected with HIV.