WHO Disease Staging System For HIV Infection and Disease in Children - Clinical Stage 4

Clinical Stage 4

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

Kaposi’s sarcoma

Oesophageal candidiasis

Central nervous system toxoplasmosis (outside the neonatal period)

HIV encephalopathy

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)

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