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Report of a WHO Consultation on Traditional Medicine and AIDS: Clinical Evaluation of Traditional Medicines and Natural Products (Geneva, 26-28 September 1990)
(1990; 20 pages) View the PDF document
Table of Contents
View the document1. Introduction
View the document2. Background information
View the document3. Preclinical considerations
View the document4. Clinical considerations
View the document5. Recommendations
View the documentAnnex 1. List of participants
View the documentAnnex 2. Guidelines for clinical trials with traditional medicine products used in the treatment of AIDS and AIDS-related diseases
View the documentAnnex 3. Proposed who clinical staging system for HIV infection and disease1

Annex 3. Proposed who clinical staging system for HIV infection and disease1

1 Weekly epidemiological record, 65: 221-228 (1990).

The WHO Global Programme on AIDS has issued the following proposed clinical staging system for HIV infection and disease. Based primarily on clinical criteria, the system is organized into four prognostic categories. It also incorporates a performance scale based on the Eastern Cooperative Oncology Group score.

Clinical stage 1:

1. Asymptomatic.

2. Persistent generalized lymphadenopathy (PGL).

Performance scale 1: asymptomatic, normal activity.

Clinical stage 2:

3. Weight loss of < 10% of body weight.

4. Minor mucocutaneous manifestations (seborrhoeic dermatitis, prurigo, fungal nail infections, recurrent oral ulcerations, angular cheilitis).

5. Herpes zoster, within the last 5 years.

6. Recurrent upper respiratory tract infection (i.e., bacterial sinusitis).

And/or Performance scale 2: symptomatic, normal activity.

Clinical stage 3:

7. Weight loss of > 10% of body weight.

8. Unexplained chronic diarrhoea, > 1 month.

9. Unexplained prolonged fever (intermittent or constant), > 1 month.

10. Oral candidiasis (thrush).

11. Oral hairy leukoplakia.

12. Pulmonary tuberculosis, within the past year.

13. Severe bacterial infections (i.e., pneumonia, pyomyositis).

And/or Performance scale 3: bed-ridden <50% of the day during the last month.

Clinical stage 4:

14. HIV wasting syndrome, as defined by the Centers for Disease Control (CDC).2

2 HIV wasting syndrome: Weight loss of > 10% of body weight, plus either unexplained chronic diarrhoea (> 1 month), or chronic weakness and unexplained prolonged fever (> 1 month).

15. Pneumocystis carinii pneumonia.

16. Toxoplasmosis of the brain.

17. Cryptosporidiosis with diarrhoea, > 1 month.

18. Cryptococcosis, extrapulmonary.

19. Cytomegalovirus (CMV) disease of an organ other than liver, spleen, or lymph nodes.

20. Herpes simplex virus (HSV) infection, mucocutaneous (> 1 month) or visceral (any duration).

21. Progressive multifocal leukoencephalopathy (PML).

22. Any disseminated endemic mycosis (i.e., histoplasmosis, coccidioidomycosis).

23. Candidiasis of the oesophagus, trachea, bronchi, or lungs.

24. Atypical mycobacteriosis, disseminated.

25. Non-typhoid Salmonella septicaemia.

26. Extrapulmonary tuberculosis.

27. Lymphoma.

28. Kaposi sarcoma (KS).

29. HIV encephalopathy, as defined by CDC.1

1 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 that could explain the findings.

And/or Performance scale 4: bedridden >50% of the day during the last month.

(Note: Both definitive and presumptive diagnoses are acceptable.)

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