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Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol 1992; 47: 1102–1114. 27  Duran S, Spire B, Raffi F et al. for the APROCO Cohort NVP-BGJ398 chemical structure Study Group. Self-reported symptoms after initiation of a protease inhibitor in HIV-infected patients and their impact on adherence to HAART. HIV Clin Trials 2001; 2: 38–45. 28  Préau M, Leport C, Villes V et al. for the ANRS CO-8 APROCO Study Group. Prevalence and predictors of deterioration of a trustful patient-provider relationship among HIV-infected persons treated with antiretroviral therapy. J Acquir Immune Defic Syndr 2008; 47: 467–471. The following recommendations concern the prevention of, and screening for, viral hepatitis in the context of HIV, including immunisation and sexual/injection drug use (IDU) behaviour modification

to reduce transmission and progression. For the assessment and evaluation of evidence, priority questions were agreed and outcomes were ranked (critical, important and not important) by members of the Writing Group. Two key questions were identified by ADAMTS5 the Writing Group in relation to acute HCV diagnosis: i) should screening be performed for HCV in adults with HIV infection 6 monthly or 12 monthly; and ii) should the screening test be HCV antibody, HCV-PCR or HCV antigen (critical outcomes: missed HCV cases, cost and transmission rates). A further key question was whether liver biopsy or hepatic elastometry is the investigation of choice in the assessment of fibrosis (critical outcome: distinction of mild/normal disease vs. established fibrosis, distinction of cirrhosis from no cirrhosis, adverse effects, cost and patient satisfaction). Details of the search strategy and literature review are contained in Appendix 2. We recommend patients with HIV infection should be screened at diagnosis for immunity against hepatitis A (1A).