The purpose is to help the health care provider to recognize the
patient with symptomatic HIV infection, as an aid to clinical
management. HIV testing, when available and affordable, can be
used to substantiate the clinical diagnosis.
b) Cardinal Findings:
Characteristic Findings (2):
thrush (in patient not taking antibiotics)
Cryptococcal meningitis (may be a cardinal finding in Africa)
Miliary, extrapulmonary or noncavitary pulmonary tuberculosis
Herpes zoster, present or past, particularly multidermatomal,
age 50 years
Kaposi sarcoma (other than as cardinal finding)
High-grade B-cell extranodal lymphoma
d) Associated Findings (2):
loss (recent unexplained) of more than 10% of baseline body
(continuous or intermittent) for more than 1 month (3)
(continuous or intermittent) for more than 1 month
Ulcers (genital or perianal) for more than 1 month
for more than 1 month (3)
complaints or findings (4)
reactions (previously not seen), e. g. to thiacetazone or
infections (severe or recurrent), e. g. warts, dermatophytes,
e) Epidemiological Risk Factors:
or past high-risk behaviour:
-- drug injecting
-- multiple sex partners
-- sex partner(s) with known AIDS or HIV infection
-- sex partner(s) with known epidemiological risk factor or
from an area with a high prevalence of HIV infection
-- males having penetrative sexual intercourse with males
history of genital ulcer disease.
of transfusion after 1975 of unscreened blood, plasma or clotting
factor; or (even if screened) from an area with a high prevalence
of HIV infection.
of scarification, tattooing, ear piercing or circumcision
using non-sterile instruments.
Kaposi sarcoma is a cardinal finding only when: (i) intraoral
lesions are present; (ii) lesions are generalised; or (iii) lesions
are rapidly progressive or invasive.
2. If no other obvious cause of immunosuppression
3. The combination of fever, weight loss and
cough is characteristic of both tuberculosis and AIDS.
4. Neurological complaints or findings associated
with HIV infection include seizures (especially focal), peripheral
neuropathy (motor or sensory), focal central motor or sensory
deficits, dementia and progressively worsening headache.
Adapted from WHO/ GPA/ IDS/ HCS/ 91.6 "Guidelines for the Clinical
Management of HIV Infection in Adults", December 1991.