clinical indicator conditions associated with untreated HIV infections and recommendations for HIV testing
Last edited 03/2018
"clinical indicator conditions " associated with untreated
HIV infections and recommendations for HIV testing
A number of conditions are commoner in those who have HIV infection. They are
associated with greater or lesser degrees of immunosuppression.
- many of these "indicator conditions " also arise frequently in those uninfected with HIV
- if any of these conditions are encountered or diagnosed during a consultation, a GP should in general, offer or refer for an HIV test; or at the very least think it through
Definitions of indicator conditions and recommendations for HIV testing:
- conditions which are AIDS defining among people living with HIV - HIV testing is strongly recommended
- neoplasms
- cervical cancer
- non-Hodgkin lymphoma
- Kaposi "s sarcoma
- bacterial infections
- Mycobacterium tuberculosis, pulmonary or extrapulmonar
- Mycobacterium avium complex (MAC) or Mycobacterium kansasii disseminated or extrapulmonary
- Mycobacterium, other species or unidentified species, disseminated or extrapulmonary
- pneumonia, recurrent (2 or more episodes in 12 months
- Salmonella septicaemia, recurrent
- viral infections
- Cytomegalovirus retinitis
- Cytomegalovirus, other (except liver, spleen, glands)
- herpes simplex, ulcer(s) > 1 month, bronchitis/pneumonitis
- progressive multifocal leucoencephalopathy
- parasitic infections
- cerebral toxoplasmosis
- Cryptosporidiosis diarrhoea, > 1 month
- Isosporiasis, > 1 month
- atypical disseminated leishmaniasis
- reactivation of American trypanosomiasis (meningo encephalitis or myocarditis)
- fungal infections
- Pneumocystis pneumonia (PCP)
- candidiasis, oesophageal
- candidiasis, bronchial/tracheal/lungs
- cryptococcosis, extrapulmonary
- Histoplasmosis, disseminated/extrapulmonary
- coccidioidomycosis, disseminated/extrapulmonary
- penicilliosis, disseminate
- conditions associated with an undiagnosed HIV prevalence of >=0.1% - strongly recommended testing
- sexually transmitted infections
- malignant lymphoma
- anal cancer/dysplasia
- cervical dysplasia
- herpes zoster
- hepatitis B or C (acute or chronic)
- mononucleosis-like illness
- unexplained leucocytopenia/
thrombocytopenia lasting > 4 weeks - seborrhoeic dermatitis/exanthema
- invasive pneumococcal disease
- unexplained fever
- candidaemia
- visceral leishmaniasis
- preganacy - implications for the unborn child
- other conditions considered likely to have an undiagnosed HIV prevalence of >0.1% - offer testing
- primary lung cancer
- lymphocytic meningitis
- oral hairy leukoplakia
- severe or atypical psoriasis
- Guillain-Barre syndrome
- mononeuritis
- subcortical dementia
- multiple sclerosis like illness
- peripheral neuropathy
- unexplained weight loss
- unexplained lymphadenopathy
- unexplained oral candidiasis
- unexplained chronic diarrohea
- unexplained chronic renal impairment
- hepatitis A
- community acquired pneumonia
- candidiasis
- conditions where not identifying the presence of HIV infection may have significant adverse implications for the individual "s clinical management
- conditions requiring aggressive immunosuppressive therapy e.g. - cancer, transplantation
- primary space occupying lesion of the brain
- idiopathic/thrombotic thrombocytopenic purpura
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