Get the free HIV Tropism Request Form - library.nhsggc.org.uk

Specialist Virology Center, New Lister Building, Glasgow Royal Infirmary, 1016 Alexandra Parade, G31 2ERHIV Genotypic Resistance Request Form Patient details (use label if available) Is sample already

How to fill out hiv tropism request form

How to fill out hiv tropism request form

1. To fill out the HIV tropism request form, follow these steps:
2. Start by entering your personal details in the designated fields, including your name, date of birth, and contact information.
3. Provide relevant medical information, such as your HIV diagnosis date, current antiretroviral therapy, and any previous tropism testing results.
4. Indicate the purpose of the request, whether it is for initial tropism assessment or to monitor tropism switch.
5. Specify the type of sample to be tested, such as plasma or tissue.
6. If applicable, provide the name and contact information of the referring healthcare provider.
7. Sign and date the form to certify that the information provided is accurate and complete.
8. Finally, submit the completed form along with the required samples to the designated laboratory.

Who needs hiv tropism request form?

1. The HIV tropism request form is required for individuals who need to determine viral tropism in their HIV infection.
2. It is typically used by healthcare providers, including infectious disease specialists, who wish to assess the tropism of the virus present in a patient.
3. This information is crucial in deciding the appropriate antiretroviral therapies, especially for individuals considering or undergoing treatment with CCR5 antagonists, such as maraviroc.
4. Patients with treatment failure or those experiencing virologic rebound may also require tropism testing to evaluate the potential need for regimen changes.
5. Therefore, individuals who fall into these categories or their healthcare providers should fill out the HIV tropism request form.

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What is hiv tropism request form?

The HIV tropism request form is a document used to request information regarding the tropism of the HIV virus in a patient's blood.

Who is required to file hiv tropism request form?

Healthcare providers or researchers who are studying HIV tropism in patients are required to file the HIV tropism request form.

How to fill out hiv tropism request form?

To fill out the HIV tropism request form, provide the patient's information, relevant medical history, and details on the HIV tropism analysis requested.

What is the purpose of hiv tropism request form?

The purpose of the HIV tropism request form is to gather information needed to analyze and study the tropism of the HIV virus in patients.

What information must be reported on hiv tropism request form?

The HIV tropism request form typically requires information such as patient demographics, HIV viral load, CD4 count, and any previous HIV tropism results.