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. Author manuscript; available in PMC: 2010 Jul 1.
Published in final edited form as: HIV Ther. 2009 Sep 1;3(5):501–526. doi: 10.2217/hiv.09.35
Clinical stage 1: asymptomatic
  • ■ Asymptomatic

  • ■ Persistent generalized lymphadenopathy

Clinical stage 2: moderate disease
  • ■ Unexplained moderate weight loss of less than 10% of baseline weight

  • ■ Recurrent upper respiratory infections (sinusitis, otitis media, tonsillitis, pharyngitis)

  • ■ Mono-dermatomal VZV (shingles)

  • ■ Recurrent oral ulceration

  • ■ Papular pruritic eruptions/dermatitis

  • ■ Seborrheic dermatitis

  • ■ Fungal nail infections

Clinical stage 3: advanced disease
  • ■ Unexplained weight loss above 10% of baseline

  • ■ Unexplained chronic diarrhea for more than 1 month

  • ■ Unexplained persistent fever (>37.5°C, intermittent or constant) for more than 1 month

  • ■ Persistent oral candidiasis

  • ■ Oral hairy leukoplakia

  • ■ Pulmonary TB

  • ■ Severe bacterial infections (e.g., pneumonia, meningitis, PID*, bone/joint infection, bacteremia)

  • ■ Multidermatomal, recurrent mono-dermatomal or ophthalmic VZV*

  • ■ Necrotizing ulcerative gingivitis, peridontitis or stomatitis

  • ■ Unexplained anemia (<8.0 gr/dl), neutropenia (<500/μl) and/or thrombocytopenia (<50,000/μl)

Clinical stage 4: severe disease
  • ■ HIV-1 wasting syndrome

  • Pneumocystis jiroveci (formerly carinii) pneumonia

  • ■ Recurrent severe bacterial pneumonia

  • ■ Chronic HSV infection (orolabial, genital or rectal for more than 1 month or visceral at any site)

  • ■ Esophageal candidiasis (or candidiasis of trachea, bronchi or lungs)

  • ■ Extrapulmonary TB

  • ■ Kaposi's sarcoma

  • Cytomegalovirus retinitis or infection of other organs

  • ■ CNS toxoplasmosis

  • ■ HIV-1 encephalopathy (AIDS dementia complex)

  • ■ Extrapulmonary cryptococcosis, including meningitis

  • ■ Disseminated non-TB mycobacterial infection

  • ■ Progressive multifocal leukoencephalopathy

  • ■ Chronic diarrhea due to cryptosporidiosis and/or isosporiasis

  • ■ Disseminated mycosis

  • ■ Recurrent septicemia

  • ■ Lymphoma (cerebral or non-Hodgkin's)

  • ■ Invasive cervical carcinoma

  • ■ Atypical disseminated leishmaniasis

  • ■ Symptomatic HIV-associated nephropathy and cardiomyopathy

*

Not part of international WHO staging, but added as frequent Botswana-specific HIV-related ‘advanced’ conditions meriting combination antiretroviral therapy initiation.

HSV: Herpes simplex virus; PID: Pelvic inflammatory disease; VZV: Varicella zoster virus.