WHO clinical staging of HIV/AIDS for adults and adolescents with confirmed HIV infection

WHO clinical staging of HIV/AIDS for adults and adolescents with confirmed HIV infection

Clinical staging is used once HIV infection has been confirmed (serological and/or virological evidence of HIV infection).

WHO clinical stage

• stage 1 - asymptomatic
  • no HIV related symptoms and no signs on examination
  • persistent generalised lymphadenopathy - painless enlarged lymphnodes >1cm in two or more non-contiguous sites (excluding inguinal) in the absence of known cause and persisting for three months or more
    
    
• stage 2 - mild symptoms
  • unexplained moderate weight loss (<10% of presumed or measured body weight)
  • recurrent upper respiratory tract infections (current event plus one or more in last six month period) e .g - sinisitus, tonsillitis, otitis media, pharygitis
  • herpes zoster
  • angular chelitis
  • recurrent oral ulceration - two or more episodes in the last six months
  • papular pruritic eruptions
  • seborrhoeic dermatitis
  • fungal nail infections e.g. - paronychia, onycholysis
    
    
• stage 3 - advanced symptoms
  • unexplained moderate weight loss (<10% of presumed or measured body weight)
  • unexplained chronic diarrhoea for longer than one month
  • unexplained persistent fever (above 37.60 C intermittent or constant, for longer than one month)
  • persistent oral candidiasis
  • oral hairy leukoplakia
  • pulmonary tuberculosis - current
  • severe bacterial infections (such as pneumonia, empyema, pyomyositis, bone or joint infection, meningitis or bacteraemia)
  • acute necrotizing ulcerative stomatitis, gingivitis, periodontitis
  • unexplained anaemia (<8g/dl), neutropaenia <0.5x10^9 per litre) or chronic thrombocytopaenia (<50x10^9 per litre)
    
    
• stage 4 - severe symptoms
  • HIV wasting syndrome
  • pneumocystis pneumonia
  • recurrent severe bacterial pneumonia
  • chronic herpes simplex infection (orolabial, genital, or anorectal of more than one moths duration or visceral at any site )
  • oesophageal candidiasis (or candidiasis of trachea, bronchi or lung)
  • extrapulmonary tuberculosis
  • Kaposi "s sarcoma
  • cytomegalovirus infection (retinitis or infection of other organs)
  • central nervous system toxoplasmosis
  • HIV enecephalopathy
  • extrapulmonary cryptococcosis including meneingitis
  • disseminated non-tuberculous mycobacterial infection
  • disseminated mycosis (1)

Reference:

• (1) World Healt h Organization (WHO) 2007. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children