The current staging system for HIV infection in children was developed in 2005 and builds upon the staging system in place since 1987. A child is defined as someone under the age of 15. This staging system also requires the presence of HIV infection: HIV antibody for children aged 18 months or more; virological or p24 antigen positive test if aged under 18 months.
Asymptomatic
Persistent generalized lymphadenopathy
Hepatosplenomegaly
Papular pruritic eruptions
Seborrhoeic dermatitis
Extensive human papilloma virus infection
Extensive molluscum contagiosum
Fungal nail infections
Recurrent oral ulcerations
Lineal gingival erythema (LGE)
Angular cheilitis
Parotid enlargement
Herpes zoster
Recurrent or chronic RTIs (otitis media, otorrhoea, sinusitis)
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)
Oral candidiasis (outside neonatal period)
Oral hairy leukoplakia
Acute necrotizing ulcerative gingivitis/periodontitis
Pulmonary TB
Severe recurrent presumed bacterial pneumonia
Conditions where confirmatory diagnostic testing is necessary
Chronic HIV-associated lung disease including bronchiectasis
Lymphoid interstitial pneumonitis (LIP)
Unexplained anaemia (<80g/l), and or neutropenia (<1000/µl) and or
thrombocytopenia (<50 000/µl) for more than one month
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
Recurrent severe presumed bacterial infections (e.g. empyema, pyomyositis, bone or joint infection, meningitis, but excluding pneumonia)
Chronic herpes simplex infection; (orolabial or cutaneous of more than one month’s duration)
Extrapulmonary Tuberculosis
Oesophageal candidiasis
Central nervous system toxoplasmosis (outside the neonatal period)
HIV encephalopathy
Conditions where confirmatory diagnostic testing is necessary
HCMV infection (CMV retinitis or infection of organs other than liver, spleen or lymph nodes; onset at age one month or more)
Extrapulmonary cryptococcosis including meningitis
Any disseminated endemic mycosis (e.g. extrapulmonary histoplasmosis, coccidiomycosis, penicilliosis)
Cryptosporidiosis
Isosporiasis
Disseminated non-tuberculous mycobacteria infection
Candida of trachea, bronchi or lungs
Visceral herpes simplex infection
Acquired HIV associated rectal fistula
Cerebral or B cell non-Hodgkin lymphoma
Progressive multifocal leukoencephalopathy (PML)
HIV-associated cardiomyopathy or HIV-associated nephropathy
The presumptive diagnosis above is designed for use where access to confirmatory diagnostic testing for HIV infection by means of virological testing (usually nucleic acid testing, NAT) or P24 antigen testing for infants and children aged under 18 months is not readily available.
Candidiasis is a fungal infection due to any type of Candida. When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Other symptoms may include soreness and problems swallowing. When it affects the vagina, it may be referred to as a yeast infection or thrush. Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina. Yeast infections of the penis are less common and typically present with an itchy rash. Very rarely, yeast infections may become invasive, spreading to other parts of the body. This may result in fevers along with other symptoms depending on the parts involved.
A mouth ulcer (aphtha) is an ulcer that occurs on the mucous membrane of the oral cavity. Mouth ulcers are very common, occurring in association with many diseases and by many different mechanisms, but usually there is no serious underlying cause. Rarely, a mouth ulcer that does not heal may be a sign of oral cancer. These ulcers may form individually or multiple ulcers may appear at once. Once formed, an ulcer may be maintained by inflammation and/or secondary infection.
Acute necrotizing ulcerative gingivitis (ANUG) is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of inter-dental papillae. This disease, along with necrotizing (ulcerative) periodontitis is classified as a necrotizing periodontal disease, one of the seven general types of gum disease caused by inflammation of the gums (periodontitis).
Oral candidiasis, also known as oral thrush among other names, is candidiasis that occurs in the mouth. That is, oral candidiasis is a mycosis of Candida species on the mucous membranes of the mouth.
Hairy leukoplakia is a white patch on the side of the tongue with a corrugated or hairy appearance. It is caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised, especially those with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). The white lesion, which cannot be scraped off, is benign and does not require any treatment, although its appearance may have diagnostic and prognostic implications for the underlying condition.
Aphthous stomatitis, or recurrent aphthous stomatitis (RAS), is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals. The informal term canker sore is also used, mainly in North America, although it may also refer to other types of mouth ulcers. The cause is not completely understood but involves a T cell-mediated immune response triggered by a variety of factors which may include nutritional deficiencies, local trauma, stress, hormonal influences, allergies, genetic predisposition, certain foods, dehydration, or some food additives.
AIDS-defining clinical conditions is the list of diseases published by the Centers for Disease Control and Prevention (CDC) that are associated with AIDS, and used worldwide as a guideline for AIDS diagnosis. CDC exclusively uses the term AIDS-defining clinical conditions, but the other terms remain in common use.
Stomatitis is inflammation of the mouth and lips. It refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration.
WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents was first produced in 1990 by the World Health Organization and updated in September 2005. It is an approach for use in resource limited settings and is widely used in Africa and Asia and has been a useful research tool in studies of progression to symptomatic HIV disease.
WHO Disease Staging System for HIV Infection and Disease was first produced in 1990 by the World Health Organization and updated in September 2005. It is an approach for use in resource limited settings and is widely used in Africa and Asia and has been a useful research tool in studies of progression to symptomatic HIV disease. Most of these conditions are opportunistic infections that are easily treated in healthy people. The staging system is different for adults and adolescents and children.
The CDC Classification System for HIV Infection is the medical classification system used by the United States Centers for Disease Control and Prevention (CDC) to classify HIV disease and infection. The system is used to allow the government to handle epidemic statistics and define who receives US government assistance.
The 1994 expanded World Health Organization AIDS case definition came around through the developments in the understanding of the spectrum of severe HIV-related illness both in developed and developing countries, and the increased availability of laboratory diagnostic methods, a meeting was convened in Geneva, Switzerland by the World Health Organization Global Programme on AIDS to review the 1985 World Health Organization AIDS surveillance case definition and to modify and expand them for use in adults and adolescents. Both the 1985 World Health Organization AIDS surveillance case definition and the 1994 expanded World Health Organization AIDS case definition are case definitions for AIDS surveillance and not for clinically staging HIV infection.
Gingivostomatitis is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva. Herpetic gingivostomatitis is often the initial presentation during the first ("primary") herpes simplex infection. It is of greater severity than herpes labialis which is often the subsequent presentations. Primary herpetic gingivostomatitis is the most common viral infection of the mouth.
Meningoencephalitis, also known as herpes meningoencephalitis, is a medical condition that simultaneously resembles both meningitis, which is an infection or inflammation of the meninges, and encephalitis, which is an infection or inflammation of the brain.
Fever of unknown origin (FUO) refers to a condition in which the patient has an elevated temperature (fever) but, despite investigations by a physician, no explanation has been found.
Mollaret's meningitis is a recurrent or chronic inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Since Mollaret's meningitis is a recurrent, benign (non-cancerous), aseptic meningitis, it is also referred to as benign recurrent lymphocytic meningitis. It was named for Pierre Mollaret, the French neurologist who first described it in 1944.
The Central Nervous System controls most of the functions of the body and mind. It comprises the brain, spinal cord and the nerve fibers that branch off to all parts of the body. The Central Nervous System viral diseases are caused by viruses that attack the CNS. Existing and emerging viral CNS infections are major sources of human morbidity and mortality. Virus infections usually begin in the peripheral tissues, and can invade the mammalian system by spreading into the peripheral nervous system and more rarely the CNS. CNS is protected by effective immune responses and multi-layer barriers, but some viruses enter with high-efficiency through the bloodstream and some by directly infecting the nerves that innervate the tissues. Most viruses that enter can be opportunistic and accidental pathogens, but some like herpes viruses and rabies virus have evolved in time to enter the nervous system efficiently, by exploiting the neuronal cell biology. While acute viral diseases come on quickly, chronic viral conditions have long incubation periods inside the body. Their symptoms develop slowly and follow a progressive, fatal course.
Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation. The most common symptom is vaginal itching, which may be severe. Other symptoms include burning with urination, a thick, white vaginal discharge that typically does not smell bad, pain during sex, and redness around the vagina. Symptoms often worsen just before a woman's period.
The stages of HIV infection are acute infection, latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers and other conditions.
Herpetic simplex keratitis is a form of keratitis caused by recurrent herpes simplex virus (HSV) infection in the cornea.