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1st August 2023
AIDS
Without treatment, HIV progresses to acquired immunodeficiency syndrome (AIDS). AIDS is defined as either an HIV positive patient with a CD4 count of less than 20 or developing an AIDS-defining illness in the context of HIV infection.
When a patient is diagnosed with AIDS, management of the underlying HIV infection with antiretroviral therapy (ART) should continue, alongside specific and supportive treatment of any associated complications. There is no cure for AIDS – treatment aims to slow the disease progression, minimise complications, and provide symptom relief. Palliative care input may be required, especially in the final stages of the illness.
ART is the single greatest intervention which prevents the progression of HIV into AIDS.
AIDS-defining illnesses
The following conditions, if they occur in the context of an HIV positive patient, are diagnostic of AIDS.
| Category | Illnesses |
|---|---|
| Malignancies | Cervical cancer Non-Hodgkin lymphoma Kaposi’s sarcoma |
| Bacterial infections | Mycobacterium species – including Mycobacterium tuberculosis, Mycobacterium avium complex and Mycobacterium kansasii Recurrent pneumonia (two or more episodes in 12 months) Recurrent Salmonella septicaemia |
| Viral infections | Cytomegalovirus (and cytomegalovirus retinitis) Herpes simplex viruses (lasting more than one month) Progressive multifocal leukoencephalopathy |
| Parasitic infections | Cerebral toxoplasmosis Cryptosporidiosis (lasting more than one month) Isosporiasis (lasting more than one month) Atypical disseminated leishmaniasis Reactivation of American trypanosomiasis (meningoencephalitis or myocarditis) |
| Fungal infections | Pneumocystis pneumonia (PCP) Candidiasis (oesophageal, bronchial/tracheal/pulmonary) Cryptococcosis (extrapulmonary) Histoplasmosis Coccidioidomycosis Penicilliosis (disseminated) |
| Other | Wasting syndrome (loss of more than 10% of body weight) |
Table 2: AIDS-defining illnesses
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