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Evaluation

Age of the patient

years

Gender of patient

Does the patient have laboratory evidence of HIV infection (antibody, antigen, virus and/or RNA)?

Lymphocyte count

Lowest percentage of CD4-positive T lymphocytes as proportion of T cells (enter from 0 to 100)

WHO performance scale (enter 1, 2, 3 or 4)?

Does the patient have acute HIV infection?

Weight loss in percent unexplained by intentional dieting (enter from 0 to 100)

Does the patient have a history for any of the following?

• persistent generalized lymphadenopathy?

• oropharyngeal Candidiasis (thrush)?

• unexplained, prolonged fever (intermittent or constant) for more than one month?

• chronic diarrhea for more than 1 month?

• oral hairy leukoplakia?

• herpes zoster within the past 5 years?

• minor mucocutaneous manifestations (seborrheic dermatitis, prurigo, fungal nail infection, recurrent oral ulcerations, angular cheilitis, etc.)?

• recurrent upper respiratory tract infections such as sinusitis?

• esophageal candidiasis?

• candida of bronchus, trachea or lungs?

• Pneumocystis carinii pneumonia?

• pulmonary tuberculosis within the past year?

• extrapulmonary tuberculosis?

• disseminated or extrapulmonary atypical mycobacterial infection?

• disseminated or extrapulmonary coccidioidomycosis?

• disseminated or extrapulmonary histoplasmosis?

• extrapulmonary cryptococcosis?

• severe bacterial infections such as pneumonia or pyomyositis?

• non-typoid Salmonella septicemia?

• chronic cryptosporidiosis (> 1 month duration)?

• wasting syndrome due to HIV?

• cytomegalovirus infection other than liver, spleen or lymph nodes?

• mucocutaneous Herpes simplex > 1 month duration)?

• visceral (lung, etc.) Herpes simplex infection?

• progressive multifocal leukoencephalopathy?

• toxoplasmosis of brain?

• HIV-related encephalitis?

• Kaposi's sarcoma?

• malignant lymphoma?

Results

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