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 Zambia HIV National Guidelines
 


Introduction  

HIV Counseling and Testing  

Sexually Transmitted Infections (STIs)  

General Principles of Antiretroviral Therapy for Chronic HIV Infection in Adults and Adolescents  

When to Start ARV Therapy for Chronic HIV Infection in Adults and Adolescents  

Initial Regimen for ARV Therapy  

Adherence  

Baseline evaluation and Monitoring  

Calculations: Ideal Body Weight, Body Mass Index and Creatinine Clearance  

ARV Therapy for Individuals with Tuberculosis Co-Infection  

Adverse Effects and Toxicity  

Immune Reconstitution Inflammatory Syndrome (IRIS)  

Changing or Stopping ART  

Treatment Failure  

Stopping ARV Therapy  

Post Exposure Prophylaxis  

Cotrimoxazole Prophylaxis  

WHO Staging in Adults and Adolescents  

Nutrition Care and Support  

Palliative Care in HIV and AIDS  

 Guide Editors
 Editor In Chief
    Joel E. Gallant, MD, MPH

Pharmacology Editor
    Paul Pham, PharmD, BCPS

Zambia Guideline Team
   Peter Mwaba MMed PhD FRCP
   Alywn Mwinga MMed
   Isaac Zulu MMed MPH
   Velepie Mtonga MMed
   Albert Mwango MBChB
   Jabbin Mulwanda MMed FCS
 

 

 

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WHO Staging in Adults and Adolescents

03-27-2008
CLINICAL STAGE 1

  • Asymptomatic
  • Persistent generalized lymphadenopathy
CLINICAL STAGE 2

  • Moderate unexplained weight loss (<10% of presumed or measured body weight)1
  • Recurrent respiratory tract infections (sinusitis, tonsillitis, otitis media, pharyngitis)
  • Herpes zoster
  • Angular cheilitis
  • Recurrent oral ulceration
  • Papular pruritic eruptions
  • Seborrhoeic dermatitis
  • Fungal nail infections
CLINICAL STAGE 3

  • Unexplained severe weight loss (>10% of presumed or measured body weight)1
  • Unexplained chronic candidiasis for > 1 month
  • Unexplained1 persistent fever (intermittent or constant for > 1 month)
  • Persistent oral candidiasis
  • Oral hairy leukoplakia
  • Pulmonary tuberculosis
  • Severe bacterial infections (e.g. pneumonia, empyema, pyomyositis, bone or joint infection, meningitis, bacteraemia)
  • Acute necrotizing ulcerative stomatitis, gingivitis or periodontitis
  • Unexplained1 anaemia (<8 g/dl ), neutropenia (<0.5 x 109/l) and/or chronic thrombocytopenia (<50 x 109 /l)
CLINICAL STAGE 4 2

  • HIV wasting syndrome
  • Pneumocystis pneumonia
  • Recurrent severe bacterial pneumonia
  • Chronic herpes simplex infection (orolabial, genital or anorectal of >1 month's duration or visceral at any site)
  • Oesophageal candidiasis (or candidiasis of trachea, bronchi or lungs)
  • Extrapulmonary tuberculosis
  • Kaposi sarcoma
  • Cytomegalovirus infection (retinitis or infection of other organs)
  • Central nervous system toxoplasmosis
  • HIV encephalopathy
  • Extrapulmonary cryptococcosis including meningitis
  • Disseminated non-tuberculous mycobacterial infection
  • Progressive multifocal leukoencephalopathy
  • Chronic cryptosporidiosis
  • Chronic isosporiasis
  • Disseminated mycosis (extrapulmonary histoplasmosis, coccidiomycosis)
  • Recurrent septicaemia (including non-typhoidal Salmonella)
  • Lymphoma (cerebral or B cell non-Hodgkin)
  • Invasive cervical carcinoma
  • Atypical disseminated leishmaniasis
  • Symptomatic HIV-associated nephropathy or HIV-associated cardiomyopathy
Definitions:





  • 1When assessing body weight in pregnant woman, should consider expected weight gain of pregnancy.
  • 2Some additional specific conditions can also be included in regional classifications, such as reactivation of American trypanosomiasis (meningoencephalitis and/or myocarditis) in WHO Region of the Americas and penicilliosis in Asia.
References:


Revised WHO clinical staging and immunological classification of HIV and case definition of HIV for surveillance 2006

REFERENCED WITHIN THIS GUIDE


 
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