Practical Approach to Metabolic Assessments in the Pediatric Human Immunodeficiency Virus Outpatient Clinic

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Metabolic assessment is not a routine part of the care of pediatric HIV-positive patients in the outpatient setting, although research studies are demonstrating an increasing prevalence of metabolic abnormalities in this population. Addition of metabolic assessments to routine clinic care can be hindered by the perception that collection of the data needed for the assessments will need too much clinic time and too many clinic resources to be practical. A method to provide metabolic assessments using minimal clinic resources while offering educational opportunities for university students was developed and implemented at the University of Florida Pediatric Immunology and Infectious Diseases weekly clinic. The success rate of metabolic assessment data collection from all clinic patients and the impact of data collection on the flow of clinic activity were monitored for a 12-month period. The metabolic assessment team interviewed 87% of all patients who came to the 454 clinic during the 12-month period and performed a complete metabolic assessment for 75% of the HIV-positive patients interviewed. Addition of metabolic assessments to the routine care of each patient did not result in any noticeable adverse effect on the functionality of the clinic. Addition of metabolic assessments to the routine clinic care of pediatric HIV positive patients can be an educational opportunity for university students and provide the clinic staff with changes in parameters indicative of metabolic abnormalities and without noticeable changes in maintaining the patient schedule at each clinic.