Identifying common opportunistic infections among people with advanced HIV disease

Overview

Advanced HIV disease (defined in persons living with HIV with a CD4 cell count of <200cells/mm3 or presenting with a WHO Stage 3/4 AIDS-defining illness) poses a challenge to many countries globally and is responsible for significant mortality and morbidity among people living with HIV. In 2017, WHO recommended a package of care for the prevention and management of advanced HIV disease. The package was composed of screening tests, diagnostics, prophylaxis, rapid antiretroviral therarpy initiation and enhanced adherence counselling.

The key screening and diagnostics tests are for the identification of tuberculosis, cryptococcal meningitis, histoplasmosis, and importantly, the assessment of CD4 cell count. 

Supporting healthcare workers, national programmes as well as representatives of civil society in improving their understanding of how best to implement these interventions is critical for better uptake, thus improving outcomes for people living with HIV. 

This policy brief summarizes key information on the use of these interventions, based on existing WHO guidelines and recommendations.