Certain findings in a patient with end-stage HIV disease may indicate that death will occur in 6 months or less.


Criteria – both of the following:

(1) laboratory finding

(2) clinical complication(s) untreated or refractory to therapy


Laboratory finding – one or both of the following:

(1) CD4-positive lymphocytes < 25 per µL

(2) viral load for HIV > 100,000 copies per mL


Clinical complications – one or more of the following:

(1) CNS lymphoma

(2) progressive multifocal leukoencephalopathy (PML)

(3) cryptosporidiosis

(4) wasting (loss of > 33% of lean body mass)

(5) Mycobacterium avium-intracellulare (MAI) complex bacteremia

(6) visceral Kaposi's sarcoma

(7) renal failure

(8) advanced AIDS dementia

(9) toxoplasmosis


Additional findings seen in the terminal phase:

(1) diarrhea for > 1 year duration

(2) serum albumin < 2.5 g/dL

(3) substance abuse

(4) age > 50 years

(5) foregoing anti-retroviral or prophylactic therapy

(6) congestive heart failure


NOTE: One factor affecting outcome is the status relative to anti-retroviral therapy. If the patient refuses therapy, or has developed resistance or unacceptable toxicity to all available agents, then the prediction is appropriate. However, a new medication can result in remarkable reversal of fortunes.


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