WHO clinical staging of HIV/AIDS for adults and adolescents with confirmed HIV infection

Last edited 03/2018

WHO clinical staging of HIV/AIDS for adults and adolescents with confirmed HIV infection

Clinical staging is used once HIV infection has been confirmed (serological and/or virological evidence of HIV infection).

WHO clinical stage

  • stage 1 - asymptomatic
    • no HIV related symptoms and no signs on examination
    • persistent generalised lymphadenopathy - painless enlarged lymphnodes >1cm in two or more non-contiguous sites (excluding inguinal) in the absence of known cause and persisting for three months or more

  • stage 2 - mild symptoms
    • unexplained moderate weight loss (<10% of presumed or measured body weight)
    • recurrent upper respiratory tract infections (current event plus one or more in last six month period) e .g - sinisitus, tonsillitis, otitis media, pharygitis
    • herpes zoster
    • angular chelitis
    • recurrent oral ulceration - two or more episodes in the last six months
    • papular pruritic eruptions
    • seborrhoeic dermatitis
    • fungal nail infections e.g. - paronychia, onycholysis

  • stage 3 - advanced symptoms
    • unexplained moderate weight loss (<10% of presumed or measured body weight)
    • unexplained chronic diarrhoea for longer than one month
    • unexplained persistent fever (above 37.60 C intermittent or constant, for longer than one month)
    • persistent oral candidiasis
    • oral hairy leukoplakia
    • pulmonary tuberculosis - current
    • severe bacterial infections (such as pneumonia, empyema, pyomyositis, bone or joint infection, meningitis or bacteraemia)
    • acute necrotizing ulcerative stomatitis, gingivitis, periodontitis
    • unexplained anaemia (<8g/dl), neutropaenia <0.5x10^9 per litre) or chronic thrombocytopaenia (<50x10^9 per litre)

  • stage 4 - severe symptoms
    • HIV wasting syndrome
    • pneumocystis pneumonia
    • recurrent severe bacterial pneumonia
    • chronic herpes simplex infection (orolabial, genital, or anorectal of more than one moths duration or visceral at any site )
    • oesophageal candidiasis (or candidiasis of trachea, bronchi or lung)
    • extrapulmonary tuberculosis
    • Kaposi "s sarcoma
    • cytomegalovirus infection (retinitis or infection of other organs)
    • central nervous system toxoplasmosis
    • HIV enecephalopathy
    • extrapulmonary cryptococcosis including meneingitis
    • disseminated non-tuberculous mycobacterial infection
    • disseminated mycosis (1)

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