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)
(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
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.
To read more or access our algorithms and calculators, please log in or register.
Purpose: To determine if a patient with advanced HIV disease or AIDS is at risk for death within the next 6 months.
Objective: severity, prognosis, stage, disease progression, end-of-life, palliative care