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 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 . Following infection with HIV, the rate of clinical disease progression varies enormously between individuals. Many factors such as host susceptibility and immune function , health care and co-infections, as well as factors relating to the viral strain may affect the rate of clinical disease progression.Revised World Health Organization (WHO) Clinical Staging of HIV/AIDS For Adults and Adolescents (2005) Primary HIV infection Asymptomatic Acute retroviral syndromeClinical stage 1 Asymptomatic Persistent generalized lymphadenopathy Clinical stage 2 Moderate and unexplained weight loss Recurrent respiratory tract infections Herpes zoster Recurrent oral ulcerations Papular pruritic eruptions Angular cheilitis Seborrhoeic dermatitis OnychomycosisClinical stage 3 Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations Conditions where confirmatory diagnostic testing is necessary Unexplained anaemia, and or neutropenia and or thrombocytopenia for more than one monthClinical stage 4 Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations Conditions where confirmatory diagnostic testing is necessary Extrapulmonary cryptococcosis including meningitis Disseminated non-tuberculous mycobacteria infection Progressive multifocal leukoencephalopathy Candida of trachea, bronchi or lungs Cryptosporidiosis Isosporiasis Visceral herpes simplex infection Cytomegalovirus infection Any disseminated mycosis Recurrent non-typhoidal salmonella septicaemia Lymphoma Invasive cervical carcinoma Visceral leishmaniasisOriginal proposal in 1990 Clinical Stage I Asymptomatic Generalised lymphadenopathy In some cases symptoms similar to those of cold flue would be manifested. Performance scale: 1: asymptomatic, normal activity.Clinical Stage II And/or performance scale 2: symptomatic, normal activity.Clinical Stage III And/or performance scale 3: bedridden < 50% of the day during last month.Clinical Stage IV The declaration of AIDS And/or performance scale 4: bedridden > 50% of the day during last month. HIV wasting syndrome: weight loss of > 10% of body weight, plus either unexplained chronic diarrhoea or chronic weakness and unexplained prolonged fever. HIV encephalopathy: clinical findings of disabling cognitive and/or motor dysfunction interfering with activities of daily living , progressing over weeks to months, in the absence of a concurrent illness or condition other than HIV infection which could explain the findings.
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