WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents

WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents

The WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents is a classification system developed by the World Health Organization (WHO) to provide a standardized method for assessing the clinical progression of HIV infection in adults and adolescents. This system is used globally to guide the management and treatment of HIV/AIDS and to facilitate the monitoring and evaluation of HIV-related health programs.

Stages of HIV Infection

The WHO staging system categorizes HIV infection into four clinical stages, each representing a different level of disease progression:

Stage 1: Primary HIV Infection

• Asymptomatic
• Persistent generalized lymphadenopathy

Stage 2: Clinical Stage 2

• Moderate unexplained weight loss (<10% of presumed or measured body weight)
• Recurrent respiratory tract infections (e.g., sinusitis, bronchitis, otitis media, pharyngitis)
• Herpes zoster
• Angular cheilitis
• Recurrent oral ulceration
• Papular pruritic eruptions
• Seborrhoeic dermatitis
• Fungal nail infections

Stage 3: Clinical Stage 3

• Unexplained severe weight loss (>10% of presumed or measured body weight)
• Unexplained chronic diarrhea for longer than one month
• Unexplained persistent fever (intermittent or constant for longer than one month)
• Persistent oral candidiasis (thrush)
• Oral hairy leukoplakia
• Pulmonary tuberculosis (current)
• Severe bacterial infections (e.g., pneumonia, empyema, pyomyositis, bone or joint infection, meningitis, bacteremia)
• Acute necrotizing ulcerative stomatitis, gingivitis, or periodontitis
• Unexplained anemia (<8 g/dl), neutropenia (<0.5 × 10^9/L) and/or chronic thrombocytopenia (<50 × 10^9/L)

Stage 4: Clinical Stage 4

• HIV wasting syndrome
• Pneumocystis pneumonia
• Recurrent severe bacterial pneumonia
• Chronic herpes simplex infection (orolabial, genital, or anorectal site for longer than one month or visceral at any site)
• Esophageal candidiasis (or candidiasis of trachea, bronchi, or lungs)
• Extrapulmonary tuberculosis
• Kaposi's sarcoma
• Cytomegalovirus infection (retinitis or infection of other organs)
• Central nervous system toxoplasmosis
• HIV encephalopathy
• Extrapulmonary cryptococcosis including meningitis
• Disseminated non-tuberculous mycobacterial infection
• Progressive multifocal leukoencephalopathy
• Chronic cryptosporidiosis
• Chronic isosporiasis
• Disseminated mycosis (e.g., histoplasmosis, coccidioidomycosis, penicilliosis)
• Recurrent non-typhoidal Salmonella bacteremia
• Lymphoma (cerebral or B-cell non-Hodgkin)
• Invasive cervical carcinoma
• Atypical disseminated leishmaniasis
• Symptomatic HIV-associated nephropathy or cardiomyopathy

Importance of the Staging System

The WHO Disease Staging System is crucial for:

• Guiding the initiation of antiretroviral therapy (ART)
• Monitoring the effectiveness of ART
• Identifying patients who may need prophylaxis for opportunistic infections
• Facilitating the collection of epidemiological data
• Standardizing the clinical management of HIV/AIDS across different regions and healthcare settings

Related Pages

• HIV
• AIDS
• World Health Organization
• Antiretroviral therapy
• Opportunistic infection
• Kaposi's sarcoma
• Pneumocystis pneumonia
• Cytomegalovirus infection
• HIV encephalopathy

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