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infection and AIDS
Clinical stage 3
U n exp lain ed severe w eight loss (> 1 0 % of p resum ed or m easured bod y w eight)
U n exp lain ed chron ic d iarrhoea for lon ger than on e m on th
U n exp lain ed p ersisten t fever (> 3 7 .5 ° C in term itten t or con stan t for > 1 m on th)
P ersisten t oral can d id iasis
Oral hairy leuk op lak ia
P ulm on ary tuberculosis
S evere bacterial in fection s ( e.g. p n eum on ia, em p yem a, p yom yositis, bon e or join t
in fection , m en in gitis, bacteraem ia)
A cute n ecrotiz in g ulcerative stom atitis, gin givitis or p eriod on titis
U n exp lain ed an aem ia ( < 8 g/ d l) , n eutrop en ia ( < 0 .5 9x 1 0 / L ) an d / or ch ron ic
throm bocytop en ia (< 5 0 x9 1 03 / L )
Clinical stage 4
H IV w astin g syn d rom e
P n eum ocystis p n eum on ia
R ecurren t severe bacterial p n eum on ia
C h ron ic h erp es sim p lex in fection ( orolabial, gen ital or an orectal of m ore th an on e
m on th‟s d uration or visceral at an y site)
Oesop hageal can d id iasis (or can d id iasis of trachea, bron chi or lun gs)
E xtrap ulm on ary tuberculosis
K ap osi‟s sarcom a
C ytom egalovirus in fection (retin itis or in fection of other organ s)
C en tral n ervous system toxop lasm osis
H IV en cep halop athy
E xtrap ulm on ary cryp tococcosis in clud in g m en in gitis
D issem in ated n on tuberculous m ycobacteria in fection
P rogressive m ultifocal leuk oen cep halop athy
C hron ic cryp tosp orid iosis
C hron ic isosp oriasis
D issem in ated m ycosis (extrap ulm on ary histop lasm osis, coccid iom ycosis)
R ecurren t sep ticaem ia (in clud in g n on typ hoid al Salmonella)
L ym p hom a (cerebral or B -cell n on -H od gk in )
In vasive cervical carcin om a
A typ ical d issem in ated leishm an iasis
S ym p tom atic H IV -associated n ep hrop athy or card iom yop athy
Note: this classification is only for adults and adolescents. Another four-stage clinical staging
has been developed for children.
Laboratory
Diagnosis of HIV infection
– T he d iagn osis of H I V in fection is m ad e w ith serological testin g.
– T estin g is d on e voluntarily w ith informed consent. T estin g is n ever m an d atory. E very
in d ivid ual h as th e righ t to k n ow or n ot to k n ow h is H I V status. T est results are
confidential to avoid d iscrim in ation . T he in d ivid ual should have access to minimum
services offerin g p re-test an d p ost-test coun sellin g, treatm en t an d sup p ort.
208
Clinical stage 3
U n exp lain ed severe w eight loss (> 1 0 % of p resum ed or m easured bod y w eight)
U n exp lain ed chron ic d iarrhoea for lon ger than on e m on th
U n exp lain ed p ersisten t fever (> 3 7 .5 ° C in term itten t or con stan t for > 1 m on th)
P ersisten t oral can d id iasis
Oral hairy leuk op lak ia
P ulm on ary tuberculosis
S evere bacterial in fection s ( e.g. p n eum on ia, em p yem a, p yom yositis, bon e or join t
in fection , m en in gitis, bacteraem ia)
A cute n ecrotiz in g ulcerative stom atitis, gin givitis or p eriod on titis
U n exp lain ed an aem ia ( < 8 g/ d l) , n eutrop en ia ( < 0 .5 9x 1 0 / L ) an d / or ch ron ic
throm bocytop en ia (< 5 0 x9 1 03 / L )
Clinical stage 4
H IV w astin g syn d rom e
P n eum ocystis p n eum on ia
R ecurren t severe bacterial p n eum on ia
C h ron ic h erp es sim p lex in fection ( orolabial, gen ital or an orectal of m ore th an on e
m on th‟s d uration or visceral at an y site)
Oesop hageal can d id iasis (or can d id iasis of trachea, bron chi or lun gs)
E xtrap ulm on ary tuberculosis
K ap osi‟s sarcom a
C ytom egalovirus in fection (retin itis or in fection of other organ s)
C en tral n ervous system toxop lasm osis
H IV en cep halop athy
E xtrap ulm on ary cryp tococcosis in clud in g m en in gitis
D issem in ated n on tuberculous m ycobacteria in fection
P rogressive m ultifocal leuk oen cep halop athy
C hron ic cryp tosp orid iosis
C hron ic isosp oriasis
D issem in ated m ycosis (extrap ulm on ary histop lasm osis, coccid iom ycosis)
R ecurren t sep ticaem ia (in clud in g n on typ hoid al Salmonella)
L ym p hom a (cerebral or B -cell n on -H od gk in )
In vasive cervical carcin om a
A typ ical d issem in ated leishm an iasis
S ym p tom atic H IV -associated n ep hrop athy or card iom yop athy
Note: this classification is only for adults and adolescents. Another four-stage clinical staging
has been developed for children.
Laboratory
Diagnosis of HIV infection
– T he d iagn osis of H I V in fection is m ad e w ith serological testin g.
– T estin g is d on e voluntarily w ith informed consent. T estin g is n ever m an d atory. E very
in d ivid ual h as th e righ t to k n ow or n ot to k n ow h is H I V status. T est results are
confidential to avoid d iscrim in ation . T he in d ivid ual should have access to minimum
services offerin g p re-test an d p ost-test coun sellin g, treatm en t an d sup p ort.
208
