Table 1 Table showing the clinical staging of HIV infection in children according to the World Health Organisation (WHO) (Adapted from WHO 2005)

 Asymptomatic

 Persistent generalized lymphadenopathy

Clinical stage 2

 Unexplained persistent hepatosplenomegaly

 Recurrent or chronic upper respiratory tract infections (otitis media, otorrhoea, sinusitis, tonsillitis)

Herpes zoster

 Lineal gingival erythema, recurrent oral ulceration, papular pruritic eruption, fungal nail infections

 Extensive wart virus infection, extensive molluscum contagiosum

 Unexplained persistent parotid enlargement

Clinical stage 3

 Unexplained moderate malnutrition not adequately responding to standard therapy

 Unexplained persistent diarrhea (14 days or more)

 Unexplained persistent fever (above 37.5 °C, intermittent or constant, for longer than one 1 month)

 Persistent oral candidiasis (after first 6 weeks of life) Oral hairy leukoplakia

 Lymph node tuberculosis Pulmonary tuberculosis

 Severe recurrent bacterial pneumonia

 Acute necrotizing ulcerative gingivitis or periodontitis

 Unexplained anemia (< 8 g/dl), neutropenia (< 0.5 × 109 /l) or chronic thrombocytopenia (< 50 × 109 /l)

 Symptomatic lymphoid interstitial pneumonitis

 Chronic HIV-associated lung disease, including bronchiectasis

Clinical stage 4

 Unexplained severe wasting, stunting or severe malnutrition not responding to standard therapy

 Pneumocystis (jirovecii) pneumonia

 Recurrent severe bacterial infections (such as empyema, pyomyositis, bone or joint infection, meningitis, but excluding pneumonia)

 Chronic herpes simplex infection (orolabial or cutaneous of more than 1 month’s duration or visceral at any site)

 Esophageal candidiasis (or candidiasis of trachea, bronchi or lungs)

 Extrapulmonary tuberculosis Kaposi sarcoma

 Cytomegalovirus infection (retinitis or infection of other organs with onset at age more than 1 month)

 Central nervous system toxoplasmosis (after the neonatal period)

 HIV encephalopathy

 Extrapulmonary cryptococcosis, including meningitis Disseminated nontuberculous mycobacterial

Infection

 Progressive multifocal leukoencephalopathy Chronic cryptosporidiosis (with diarrhoea) Chronic isosporiasis

 Disseminated endemic mycosis (extrapulmonary histoplasmosis, coccidioidomycosis, penicilliosis)

 Cerebral or B-cell non-Hodgkin lymphoma

 HIV-associated nephropathy or cardiomyopathy