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Table 1 WHO staging

From: Misdiagnosis of HIV treatment failure based on clinical and immunological criteria in Eastern and Central Kenya

WHO clinical stage 1

 1. Asymptomatic

 2. Persistent generalized lymphadenopathy

WHO clinical stage 2

 1. Moderate unexplained weight loss (<10% of presumed or measured body weight).

 2. Recurrent respiratory tract infections (RTIs, sinusitis, bronchitis, otitis media, pharyngitis).

 3. Herpes zoster

 4. Angular cheilitis

 5. Recurrent oral ulcerations

 6. Papular pruritic eruptions

 7. Seborrhoeic dermatitis

 8. Fungal nail infections of fingers

WHO clinical stage 3

 1. Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations.

 2. Severe weight loss (>10% of presumed or measured body weight).

 3. Unexplained chronic diarrhea for longer than one month.

 4. Unexplained persistent fever (intermittent or constant for longer than one month).

 5. Oral candidiasis.

 6. Oral hairy leukoplakia.

 7. Pulmonary tuberculosis

 8. Severe presumed bacterial infections (e.g. pneumonia, empyema, pyomyositis, bone or Joint infection, meningitis, bacteraemia).

 9. Acute necrotizing ulcerative stomatitis, gingivitis or periodontitis.

 10. Conditions where confirmatory diagnostic testing is necessary

  • Unexplained anaemia (<8 g/dl), and or neutropenia (<500/mm3) and or

  • Thrombocytopenia (<50,000/ mm3) for more than one month.

WHO clinical stage 4

Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple

investigations

 1. HIV wasting syndrome

 2. Pneumocystis pneumonia

 3. Recurrent severe or radiological bacterial pneumonia

 4. Chronic herpes simplex infection (orolabial, genital or anorectal of more than one month’s duration)

 5. Oesophageal candidiasis

 6. Extrapulmonary TB

 7. Kaposi’s sarcoma

 8. Central nervous system toxoplasmosis

 9. HIV encephalopathy

Conditions where confirmatory diagnostic testing is necessary:

 1. Extrapulmonary cryptococcosis including meningitis

 2. Disseminated non-tuberculous mycobacteria infection

 3. Progressive multifocal leukoencephalopathy

 4. Candida of trachea, bronchi or lungs

 5. Cryptosporidiosis

 6. Isosporiasis

 7. Visceral herpes simplex infection

 8. Cytomegalovirus infection (retinitis or of an organ other than liver, spleen or lymph nodes)

 9. Any disseminated mycosis (e.g. histoplasmosis, coccidiomycosis, penicilliosis)

 10. Recurrent non-typhoidal salmonella septicaemia

 11. Lymphoma (cerebral or B cell non-Hodgkin)

 12. Invasive cervical carcinoma

 13. Visceral leishmaniasis