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Routine Care of the Healthy Patient TABLE 4. U.S. Preventive Services Task Force Recommendations on Screening for lnfectious Diseases lnfectious 5creening Screening Test Populations at Risk Disease Recommendation Chlamydia and Screen all sexually active Nucleic acid amplification Persons with a history of STls, persons with new or gonorrhea women aged <24 y and test multiple sexual partners, those who use condoms women aged >24 y who are inconsistently, persons who exchange sex for money at increased risk for infection or drugs HIV Perform one-time Combination HIV antibody Men who have sex with men, active users of injection screening for all adults immunoassay/p24 antigen drugs, persons who engage in risky behaviors aged 1 5-65 y; repeat test (unprotected vaginal or anal intercourse; sexual screening for adults at partners who are HIV infected, bisexual, or users of increased risk injection drugs; transactional sex), persons with other STls, persons who live and receive care in a high- prevalence setting (HlV seroprevalence oI >1%) HBV Screen all adults at high Hepatitis B surface antigen Persons born in countries with >2% prevalence of HBV risk test; obtain antibodies infection, persons with HIV infection, users of injection (anti-HBs, anti-HBc) to drugs, men who have sex with men, household differentiate between contacts or sexual partners of persons with HBV immunity and in{ection infection HCV Perform one time Anti-HCV anti body test, Users of injection/intranasal drugs, persons who screening in all patients followed by PCR viral load received a blood transfusion before 1992, persons aged 1 B-79 y test if result is positive receiving long-term hemodialysis, prisoners, and persons who received unregulated tattoos Syphilis Screen all adults at VDRL or RPR test Persons with HIV infection, prisoners, men who have sex increased risk with men, persons who exchange sex for money or drugs Latent TB Screen populations at Tuberculin skin test or Persons born in or former residents of countries with increased risk interferon-'y release assay high TB prevalence, close contacts o{ persons with known or suspected TB, persons who live or work in high-risk settings

TABLE 4. U.S. Preventive Services Task Force Recommendations on Screening for lnfectious Diseases lnfectious 5creening Screening Test Populations at Risk Disease Recommendation Chlamydia and Screen all sexually active Nucleic acid amplification Persons with a history of STls, persons with new or gonorrhea women aged <24 y and test multiple sexual partners, those who use condoms women aged >24 y who are inconsistently, persons who exchange sex for money at increased risk for infection or drugs HIV Perform one-time Combination HIV antibody Men who have sex with men, active users of injection screening for all adults immunoassay/p24 antigen drugs, persons who engage in risky behaviors aged 1 5-65 y; repeat test (unprotected vaginal or anal intercourse; sexual screening for adults at partners who are HIV infected, bisexual, or users of increased risk injection drugs; transactional sex), persons with other STls, persons who live and receive care in a high- prevalence setting (HlV seroprevalence oI >1%) HBV Screen all adults at high Hepatitis B surface antigen Persons born in countries with >2% prevalence of HBV risk test; obtain antibodies infection, persons with HIV infection, users of injection (anti-HBs, anti-HBc) to drugs, men who have sex with men, household differentiate between contacts or sexual partners of persons with HBV immunity and in{ection infection HCV Perform one time Anti-HCV anti body test, Users of injection/intranasal drugs, persons who screening in all patients followed by PCR viral load received a blood transfusion before 1992, persons aged 1 B-79 y test if result is positive receiving long-term hemodialysis, prisoners, and persons who received unregulated tattoos Syphilis Screen all adults at VDRL or RPR test Persons with HIV infection, prisoners, men who have sex increased risk with men, persons who exchange sex for money or drugs Latent TB Screen populations at Tuberculin skin test or Persons born in or former residents of countries with increased risk interferon-'y release assay high TB prevalence, close contacts o{ persons with known or suspected TB, persons who live or work in high-risk settings reagrn; STI = se^ually transmited infection; TB = tuberculosis; VDRL = venereal disease research laboratory.

TABLE 4. U.S. Preventive Services Task Force Recommendations on Screening for lnfectious Diseases lnfectious 5creening Screening Test Populations at Risk Disease Recommendation Chlamydia and Screen all sexually active Nucleic acid amplification Persons with a history of STls, persons with new or gonorrhea women aged <24 y and test multiple sexual partners, those who use condoms women aged >24 y who are inconsistently, persons who exchange sex for money at increased risk for infection or drugs HIV Perform one-time Combination HIV antibody Men who have sex with men, active users of injection screening for all adults immunoassay/p24 antigen drugs, persons who engage in risky behaviors aged 1 5-65 y; repeat test (unprotected vaginal or anal intercourse; sexual screening for adults at partners who are HIV infected, bisexual, or users of increased risk injection drugs; transactional sex), persons with other STls, persons who live and receive care in a high- prevalence setting (HlV seroprevalence oI >1%) HBV Screen all adults at high Hepatitis B surface antigen Persons born in countries with >2% prevalence of HBV risk test; obtain antibodies infection, persons with HIV infection, users of injection (anti-HBs, anti-HBc) to drugs, men who have sex with men, household differentiate between contacts or sexual partners of persons with HBV immunity and in{ection infection HCV Perform one time Anti-HCV anti body test, Users of injection/intranasal drugs, persons who screening in all patients followed by PCR viral load received a blood transfusion before 1992, persons aged 1 B-79 y test if result is positive receiving long-term hemodialysis, prisoners, and persons who received unregulated tattoos Syphilis Screen all adults at VDRL or RPR test Persons with HIV infection, prisoners, men who have sex increased risk with men, persons who exchange sex for money or drugs Latent TB Screen populations at Tuberculin skin test or Persons born in or former residents of countries with increased risk interferon-'y release assay high TB prevalence, close contacts o{ persons with known or suspected TB, persons who live or work in high-risk settings reagrn; STI = se^ually transmited infection; TB = tuberculosis; VDRL = venereal disease research laboratory. TABLE 5. Screening for lnfectious Diseases in High-Risk 13 to 64 years. Pregnancy is an indication fbr repeat screening Populations fbr HIV infection. The USPS'l'F suggests repeat screening of' Specific Populations Recommended Screenino persons at increased risk for HIV (such as men who have sex with men and active injection drug users) but does not specily Pregnant women Chlamydia and gonorrhea, hepatitis B, HlV, syphilis, the interval for repeat screening. The CDC recommends at asymptomatic bacteriuria least annual screening lbr r.nen who have sex with men but Persons engaging in high-risk Hepatitis B and C, HIV notes that more frequent screening may be appropriate in sexual behavior syphilis other populations. Combination IllV antibody immunoassay/ Men who have sex with men Chlamydia and gonorrhea, p24 antigen testing is recommended lbr screening. Diagnosis hepatitis B, HlV, syphilis of HIV is discussed in MKSAP 19 lnlbctious Disease. lnjection drug users Hepatitis B and C, HIV I(EY POITT Prisoners Hepatitis C, hepatitis B", syphilis, tuberculosis o The U.S. Preventive Services]ask Force recommends that all persons aged 15 to 65 years receive one time Persons receiving Hepatitis Bu and C, hemodialysis tubercu losis HIV screening and persons 18 to 79 years receive one Persons born in or living in Hepatitis B and tuberculosis time hepatitis C screening regardless of risk. countries with22"/" hepatitis B depending on prevalence of virus prevalenceb disease Health care workers Tuberculosis (baseline testing Screening for Substance Use Disorders only); pre'employment 'l'he USPSTF recommends tl.rat cliniciar.rs ask all adults about verification of immunity to hepatitis B virus, measles, tobacco use, advise them to stop using tobacco, and provide mumps, rubella, and varicella behavioral intervention and pharmacotherapy for tobacco cessa

TABLE 5. Screening for lnfectious Diseases in High-Risk 13 to 64 years. Pregnancy is an indication fbr repeat screening Populations fbr HIV infection. The USPS'l'F suggests repeat screening of' Specific Populations Recommended Screenino persons at increased risk for HIV (such as men who have sex with men and active injection drug users) but does not specily Pregnant women Chlamydia and gonorrhea, hepatitis B, HlV, syphilis, the interval for repeat screening. The CDC recommends at asymptomatic bacteriuria least annual screening lbr r.nen who have sex with men but Persons engaging in high-risk Hepatitis B and C, HIV notes that more frequent screening may be appropriate in sexual behavior syphilis other populations. Combination IllV antibody immunoassay/ Men who have sex with men Chlamydia and gonorrhea, p24 antigen testing is recommended lbr screening. Diagnosis hepatitis B, HlV, syphilis of HIV is discussed in MKSAP 19 lnlbctious Disease. lnjection drug users Hepatitis B and C, HIV I(EY POITT Prisoners Hepatitis C, hepatitis B", syphilis, tuberculosis o The U.S. Preventive Services]ask Force recommends that all persons aged 15 to 65 years receive one time Persons receiving Hepatitis Bu and C, hemodialysis tubercu losis HIV screening and persons 18 to 79 years receive one Persons born in or living in Hepatitis B and tuberculosis time hepatitis C screening regardless of risk. countries with22"/" hepatitis B depending on prevalence of virus prevalenceb disease Health care workers Tuberculosis (baseline testing Screening for Substance Use Disorders only); pre'employment 'l'he USPSTF recommends tl.rat cliniciar.rs ask all adults about verification of immunity to hepatitis B virus, measles, tobacco use, advise them to stop using tobacco, and provide mumps, rubella, and varicella behavioral intervention and pharmacotherapy for tobacco cessa 'Recomrnendations from the Centers for Disease Control and Prevention. tion (grade A) (see MKSAP 19 General lnternal Medicine 1).'l'he ACC/AHA recommend assessment of tobacco use at every visit. "lncluding most of sub Saharan Africa, central and southeast Asra, and parts o{ South Ame rica. See https://wwwnc.cd c.gov/trave l/yel lowbo ok/2020/travel The USPSTF supports asking all adults about alcohol related infectious-diseases/hepatltls b for fudher details. misuse and providing persons engaged in risky or hazardous

'Recomrnendations from the Centers for Disease Control and Prevention. tion (grade A) (see MKSAP 19 General lnternal Medicine 1).'l'he ACC/AHA recommend assessment of tobacco use at every visit. "lncluding most of sub Saharan Africa, central and southeast Asra, and parts o{ South Ame rica. See https://wwwnc.cd c.gov/trave l/yel lowbo ok/2020/travel The USPSTF supports asking all adults about alcohol related infectious-diseases/hepatltls b for fudher details. misuse and providing persons engaged in risky or hazardous 7