HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

Performance Measure: Lipid Screening OPR-Related Measure: No

Percentage of clients with HIV infection on HAART who had a fasting lipid panel1 during the measurement 

year

Numerator: 

Number of HIV-infected clients who: 

• were prescribed HAART, and 

• had a fasting lipid panel in the measurement year 

Denominator: Number of HIV-infected clients who are on HAART and who had a medical visit with a 

provider with prescribing privileges2 at least once in the measurement year 

Patient 

Exclusions: None 

Data Element: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, was the client on HAART?(Y/N) 

i. If the client was on HAART, did he/she have a fasting lipid 

panel during the measurement year? (Y/N) 

Data Sources: 

• Electronic Medical Record/Electronic Health Record 

• CAREWare, Lab Tracker, or other electronic data base 

• HIVQUAL reports on this measure for grantee under review 

• Medical record data abstraction by grantee of a sample of records 

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison: 

National HIVQUAL Data:3

2003 2004 2005 2006 

Top 10% 100% 100% 100% 100% 

Top 25% 100% 100% 97.9% 100% 

Mean* 80.7% 79.1% 80.2% 84.7% 

*From HAB database 

Outcome 

Measures for 

Consideration: 

o Incidence of cardiovascular events in clinic population 

o Incidence of metabolic syndrome in the clinic population

Basis for Selection and Placement in Group 2: 

Changes in body shape, fat distribution & metabolism occur with frequency among HIV-infected patients, 

particularly those prescribed HAART. Metabolic changes that have been observed include 

hypertriglyceridemia, low high-density-lipoprotein (HDL) cholesterol and changes in LDL cholesterol. 

Although rates of prevalence vary, studies have found the rate of prevalence for metabolic syndrome to be 

almost 25% in a population of patients taking HAART4

, where metabolic syndrome is defined as the presence 

of at least 3 of the following: hypertriglyceridemia, low high-density lipoprotein cholesterol, hypertension, 

abdominal obesity or high serum glucose.5

 

All patients should receive a lipid profile at least once a year in order to monitor general health. For patients 

on HAART, lipid level monitoring is important to detect side effects and to identify patients who may require 

August 1, 2008 Page 13 
HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

treatment. 

Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment 

decisions that affect a sizable population. Measure has a strong evidence base supporting the use. 

US Public Health Guidelines: 

As part of pretreatment evaluation: “The following laboratory tests should be performed for each new 

patient during initial patient visits:...and serum lipids if considered at risk for cardiovascular disease and for 

baseline evaluation prior to initiation of combination antiretroviral therapy (AIII)...”6 

References/Notes: 

1

A fasting lipid panel consists of fasting cholesterol, HDL, calculated LDL and triglycerides. 2

A “provider with prescribing privileges” is a health care professional who is certified in their jurisdiction to 

prescribe ARV therapy. 

3

(http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf) The 

HIVQUAL indicator includes all patients on ARV therapy. 

4

 Jacobson DL, Tang AM, Spiegalman D. Incidence of Metabolic Syndrome in a Cohort of HIV-Infected 

Adults and Prevalence Relative to the US Population (National Health and Nutrition Examination Survey)..J 

Acquir Immune Defic Syndr. 2006 Sep 14

5

 Jacobson DL, Tang AM, Spiegalman D. Incidence of Metabolic Syndrome in a Cohort of HIV-Infected 

Adults and Prevalence Relative to the US Population (National Health and Nutrition Examination Survey)..J 

Acquir Immune Defic Syndr. 2006 Sep 14 

6

 Panel on Antiretroviral Guidelines for Adult and Adolescents. Guidelines for the use of antiretroviral 

agents in HIV-1-Infected Adults and Adolescents. Department of Health and Human Services. January 29, 

2008, p. 3, 82. Available at http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf) Accessed April 

2, 2008. 

August 1, 2008 Page 14