The definition of Advanced HIV Disease (AHD) is any patient presenting late with:
- WHO clinical Stage 3 or 4
- Children from 5 years of age, adolescents and adults with CD4 count < 200cells/mmᶟ
- All children < 5 years age (a child who has been on established ART for >1 year and older than 2 years can be excluded)
To note:
- A late presenter as defined as any patient who presents with a CD4 count <350 cells/mmᶟ or an AIDS defining event, such as the occurrence of an opportunistic infection or malignancy.
- CD4 is the best indicator of disease stage and mortality risk: patients with CD4 count< 100 cells/mm are considered severely immuno-compromised. Very advanced disease defined is as CD4 count <50 cells/mmᶟ.