WHO clinical staging criteria

Staging is not indicated to start ART but it is useful for following up patients on treatment and can be a sign of treatment failure.

Stage Diagnosis
1 Asymptomatic
Persistent generalized LAP
2 Unexplained hepatosplenomegaly
Extensive wart infection
Papular pruritic eruptions
Extensive molluscum contagiosum
Parotid enlargement
Recurrent oral ulcerations
Herpes Zoster
Lineal gingival erythema
Recurrent/ Chronic URTI
Fungal nail infections
3 Moderate unexplained malnutrition
  • W/H 70-80%
  • W/A below lower line in growth curve
  • Weight loss > 10% (over 3 months)
  • Failure to gain weight over 6 m in under fives
  • MUAC 11 – 11.9 cm in 1-5 year olds
Unexplained persistent diarrhoea (>14days)
Unexplained persistent fever (for >1 month)
Persistent/ recurrent oral candida
Oral hairy leukoplakia
Necrotizing gingivitis periodontitis
Symptomatic LIP
Chronic HIV - lung disease
Unexplained anaemia (<8g/dl), neutropenia (<500/mm3)
or thrombocytopenia (<50 000/mm3)
HIV - cardiomyopathy or nephropathy
Lymph node TB
Pulmonary tuberculosis
Severe recurrent bacterial pneumonia
4 Severe unexplained malnutrition
  • W/H < 70%
  • MUAC < 11 cm in 1-5 year olds
Oesophageal candida (or trachea, bronchi, lungs)
Central nervous system toxoplasmosis
CMV infection (onset at age over 1 month)
Pneumocystis pneumonia
Acquired HIV-associated rectal fistula
Recurrent severe presumed bacterial infections (excluding pneumonia)
Progressive multifocal leukoencephalopathy
Cerebral or B cell non-Hodgkin lymphoma
Herpes simplex infection (for over 1 month)
HIV encephalopathy (consult senior)
Extrapulmonary tuberculosis
Extrapulmonary cryptococcosis
Kaposi sarcoma
Extrapulmonary TB (excluding LN TB)

Presumed Severe HIV for children under 12 months, who have not had PCR

A positive antibody test plus two or more of the following: Or one of the following: