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STAGING AND CLINICAL 
MANIFESTATION OF HIV
 HIV classification system is used to 
categorize the stage of paediatric disease by 
using two parameters: 
 clinical s...
REVISED WHO CLINICAL 
STAGING OF HIV/AIDS 
FOR INFANTS AND 
CHILDREN
 Asymptomatic 
 PGL (persistent generalized 
lymphadenopathy)
 Hepatosplenomegaly 
 Papular pruritic eruptions 
 Seborrhoeic dermatitis
 Extensive human papilloma virus 
infection(condyloma acuminata)
 Extensive molluscum contagiosum 
 Fungal nail infections 
 Recurrent or chronic RTIs (otitis media, 
otorrhoea, sinusi...
 Recurrent oral ulcerations 
 Linear gingival erythema (LGE) 
 Angular cheilitis
 Parotid enlargement 
 Herpes zoster
Conditions where a presumptive diagnosis 
can be made on the basis of clinical signs or 
simple investigations 
 Moderat...
 Oral candidiasis (outside neonatal period ) 
 Severe recurrent presumed bacterial 
pneumonia
 Oral hairy leukoplakia 
 Pulmonary TB
 Acute necrotizing ulcerative 
gingivitis/periodontitis
Conditions where confirmatory diagnostic 
testing is necessary 
 Chronic HIV-associated lung disease 
including brochiec...
Conditions where a presumptive diagnosis 
can be made on the basis of clinical signs or 
simple investigations 
 Unexpla...
 Recurrent severe presumed bacterial 
infections (e.g. empyema, pyomyositis, bone 
or joint infection, meningitis, but ex...
 Chronic herpes simplex infection; (orolabial 
or cutaneous of more than one month’s 
duration)
 Kaposi’s sarcoma 
 Oesophageal candidiasis
Conditions where confirmatory diagnostic 
testing is necessary 
 CMV infection (CMV retinitis or infection of 
organs ot...
 Extrapulmonary cryptococcosis including 
meningitis 
 Any disseminated endemic mycosis (e.g. 
extrapulmonary histoplasm...
 Disseminated non-tuberculous mycobacteria 
infection 
 Progressive multifocal leukoencephalopathy 
(PML) 
 Candida of ...
 Visceral herpes simplex infection 
 Acquired HIV associated rectal fistula 
 Cerebral or B cell non-Hodgkin lymphoma
IMMUNE STATUS Age 
Up to 12 
months 
13-59 
months 
5 years or 
over 
Not significant 
immunosuppression 
>35% >25% >500/m...
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Staging and clinical manifestation of HIV

  1. 1. STAGING AND CLINICAL MANIFESTATION OF HIV
  2. 2.  HIV classification system is used to categorize the stage of paediatric disease by using two parameters:  clinical status  degree of immunologic impairment.
  3. 3. REVISED WHO CLINICAL STAGING OF HIV/AIDS FOR INFANTS AND CHILDREN
  4. 4.  Asymptomatic  PGL (persistent generalized lymphadenopathy)
  5. 5.  Hepatosplenomegaly  Papular pruritic eruptions  Seborrhoeic dermatitis
  6. 6.  Extensive human papilloma virus infection(condyloma acuminata)
  7. 7.  Extensive molluscum contagiosum  Fungal nail infections  Recurrent or chronic RTIs (otitis media, otorrhoea, sinusitis)
  8. 8.  Recurrent oral ulcerations  Linear gingival erythema (LGE)  Angular cheilitis
  9. 9.  Parotid enlargement  Herpes zoster
  10. 10. Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations  Moderate unexplained malnutrition not adequately responding to standard therapy  Unexplained persistent diarrhoea (14 days or more )  Unexplained persistent fever (intermittent or constant, for longer than one month)
  11. 11.  Oral candidiasis (outside neonatal period )  Severe recurrent presumed bacterial pneumonia
  12. 12.  Oral hairy leukoplakia  Pulmonary TB
  13. 13.  Acute necrotizing ulcerative gingivitis/periodontitis
  14. 14. Conditions where confirmatory diagnostic testing is necessary  Chronic HIV-associated lung disease including brochiectasis  Lymphoid interstitial pneumonitis (LIP)  Unexplained anaemia (<8g/dl), and or neutropenia (<1000/mm3) and thrombocytopenia (<50 000/ mm3) for more than one month
  15. 15. Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations  Unexplained severe wasting or severe malnutrition not adequately responding to standard therapy  Pneumocystis pneumonia
  16. 16.  Recurrent severe presumed bacterial infections (e.g. empyema, pyomyositis, bone or joint infection, meningitis, but excluding pneumonia)  HIV encephalopathy  Extrapulmonary TB  CNS toxoplasmosis (outside the neonatal period)
  17. 17.  Chronic herpes simplex infection; (orolabial or cutaneous of more than one month’s duration)
  18. 18.  Kaposi’s sarcoma  Oesophageal candidiasis
  19. 19. Conditions where confirmatory diagnostic testing is necessary  CMV infection (CMV retinitis or infection of organs other than liver, spleen or lymph nodes; onset at age one month or more)
  20. 20.  Extrapulmonary cryptococcosis including meningitis  Any disseminated endemic mycosis (e.g. extrapulmonary histoplasmosis, coccidiomycosis,penicilliosis)  Cryptosporidiosis  Isosporiasis
  21. 21.  Disseminated non-tuberculous mycobacteria infection  Progressive multifocal leukoencephalopathy (PML)  Candida of trachea, bronchi or lungs  HIV-associated cardiomyopathy or HIV-associated nephropathy
  22. 22.  Visceral herpes simplex infection  Acquired HIV associated rectal fistula  Cerebral or B cell non-Hodgkin lymphoma
  23. 23. IMMUNE STATUS Age Up to 12 months 13-59 months 5 years or over Not significant immunosuppression >35% >25% >500/mm3 Mild immunosuppression 25−34% 20−24% 350−499/m m3 Advanced immunosuppression 20−24% 15−19% 200−349/m m3 Severe immunosuppression <20% <15% <200/mm3
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Staging and clinical manifestation of HIV

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