WHO CLINICAL STAGING SYSTEM FOR HIV INFECTION AND DISEASE

Patients with HIV infection who are aged 13 years or older are clinically staged on the basis of the presence of the clinical condition, or performance score, belonging to the highest level. (this staging differs from that used for AIDS surveillance)

CLINICAL STAGE 1

• Asymptomatic
• Generalised lymphadenopathy,
• Perfomance scale 1: asymptomatic, normal activity

CLINICAL STAGE 2

• Weight loss < 10% body weight (and > 5%)

• Minor mucocutaneous manifestations (seborrheic dermatitis: prurigo, fungal nail infections, recurrent oral ulcerations, angular stomatitis)

• Herpes Zoster within the last 5 years

• Recurrent upper respiratory tract infections (i.e. bacterial sinusitis)

• And/or performance scale 2: symptomatic, normal activity

CLINICAL STAGE 3

• Weight loss > 10% body weight
• Unexplained chronic diarrhoea > 1 month
• Unexplained prolonged fever (intermittent or constant) > 1 month
• Oral candidiasis
• Oral hairy leukoplakia
• Pulmonary tuberculosis within the previous year
• Severe bacterial infections(ie. Pneumonia, pyomyositis)
• And/or performance scale 3: bed-ridden < 50% of the day during the last month

CLINICAL STAGE 4

• HIV wasting syndrome (as defined by CDC (i.e weight loss > 10% body weight, plus either unexplained chronic diarrhoea (. 1 month), or chronic weakness and unexplained prolonged fever (> 1 month))

• Pneunmocysitis carinii pneumonia

• Toxoplasmosis of the brain

• Cryptosporidiosis with diarrhoea > 1 month

• Cryptococcus (extrapulmonary)

• Cytomegalovirus of an organ other than the liver, spleen or lymph nodes

• Herpes simplex virus infection, mucocutaneous > 1 month, or visceral any duration

• Progressive multifocal leukoencephalopathy

• Any disseminated endemic mycosis

• Candidiasis of the oesophagus, trachea, bronchi or lungs

• Atypical mycobacteriosis, disseminated

• Non-typhoidal salmonella septicaemia

• Extrapulmonary tuberculosis

• Lymphoma

• Kaposi's sarcoma

• HIV encephalopathy (as defined by CDC)

• And/or performance scale 4: bed-ridden > 50% of the day during last month