Are laboratory tests required before initiating Vehoza (generic name) therapy?

Laboratory Testing Requirements Before Initiating Vehoza

Laboratory testing is required before initiating Vehoza therapy, including HIV RNA level, CD4+ cell count, general health labs (lipids, kidney and liver function, CBC, glucose), and testing for potential co-infections. 1

Required Laboratory Tests Before Starting Vehoza

According to the International Antiviral Society-USA panel's 2024 recommendations, the following laboratory tests are recommended prior to initiating antiretroviral therapy:

1. HIV-specific tests:

   • HIV RNA level (viral load)
   • CD4+ cell count (evidence rating: AIIa)

2. General health assessment:

   • Lipid levels
   • Kidney function tests
   • Liver function tests
   • Complete blood count
   • Glucose level
   • Pregnancy status (in people of childbearing potential) (evidence rating: AIa)

3. Resistance testing:

   • Reverse transcriptase–protease genotype (evidence rating: AIIa)

4. Co-infection screening:

   • Viral hepatitis A, B, and C
   • Latent tuberculosis
   • Sexually transmitted infections (evidence rating: AIIa)

5. Additional testing for specific populations:

   • If CD4+ cell count is <100 cells/μL, testing for cryptococcal antigen is recommended (evidence rating: AIa)
   • If symptoms suggest acute infections (e.g., STIs, Mycobacterium avium complex, tuberculosis, cryptococcus), appropriate testing is recommended (evidence rating: AIIa)

Clinical Implications and Timing

While these laboratory tests are required before starting Vehoza, it's important to note that the results should not delay the initiation of therapy 1. The guidelines specifically state that "immediate follow-up of these results is recommended to maximize safety, but the results of these diagnostic tests should not delay starting ART" (evidence rating: AIII).

Follow-up Laboratory Monitoring

After initiating Vehoza:

• HIV RNA levels should be measured at 4-6 weeks after starting therapy
• Adherence and tolerability should be assessed at this time
• If HIV RNA levels have not decreased to below 200 copies/mL after 12-24 weeks of therapy (and adherence seems adequate), a genotype based on the person's regimen is advised

Special Considerations

• InSTI resistance testing is not routinely recommended in newly diagnosed HIV patients unless they have previously taken cabotegravir-containing PrEP or there is reason to believe they acquired HIV from a partner with InSTI-resistant virus
• Regular monitoring of urine glucose and protein levels should be performed in individuals starting tenofovir disoproxil fumarate and at least once a year thereafter

Best Practices for Laboratory Testing

The American College of Cardiology Foundation/American Heart Association guidelines support targeted laboratory testing based on clinical indications rather than routine screening 2. This aligns with the specific pre-treatment laboratory requirements for Vehoza, which are designed to establish baseline values and identify any conditions that might affect treatment safety or efficacy.

Remember that these laboratory tests are essential not only for ensuring the safe initiation of Vehoza but also for establishing baseline values that will be important for monitoring treatment response and potential adverse effects throughout therapy.