A Hidden Crisis: The Impact of Opportunistic Infections
The World Health Organization defines AHD by a CD4 count below 200 cells/mm³ or WHO Stage 3 or 4 illness. This includes people who have never received antiretroviral therapy (ART) and those returning to care after interrupted treatment. All children younger than five years of age are considered to have advanced HIV disease.
People with AHD are at high risk of death. Even after starting treatment, this risk increases with decreasing CD4 cell count. The most common causes of severe illness and death are tuberculosis, severe bacterial infections and cryptococcal meningitis.
Advanced HIV disease (AHD) remains one of the greatest threats to ending AIDS for good. It affects millions of people who either begin treatment late, face treatment failure, or return to care after an interruption—each case a reminder of the urgent need to strengthen every step of the HIV response.
People living with advanced HIV disease make up nearly one-third of all individuals in active care. They are at higher risk of severe opportunistic infections like tuberculosis, bacterial infections, and cryptococcal meningitis, which can quickly become fatal without timely diagnosis and treatment.
Yet, despite the clear burden, national strategies and funding priorities often fail to address the complexity of AHD. Without dedicated resources for diagnosis, treatment, and long-term retention in care, preventable deaths continue—especially across sub-Saharan Africa.
EGPAF is leading efforts to close these deadly gaps
Patient-centered, differentiated models of care improve how individuals are screened, diagnosed, treated, and supported. We are working to expand access to the full WHO-recommended package of care for people with advanced HIV disease, including:
CD4 testing
Point-of-care screening tools
Access to new and lifesaving medicines
By combining innovation, advocacy, and partnership with ministries of health, EGPAF is helping ensure that no person living with HIV is left behind—no matter when or how they enter care.
Keep Reading
EGPAF is committed to ensuring that every person living with HIV has access to timely care, lifesaving treatment, and the chance to live a long, healthy life. Read more stories about how we’re improving diagnosis and treatment for people with advanced HIV disease.
Journal Articles
Understanding Health Systems Challenges in Providing Advanced HIV Disease (AHD) Care in a Hub and Spoke Model
Published February 2024
Topics:
Advanced HIV Disease (AHD)
Countries:
Malawi
Project Brief
Appraisal of the Risk Stratification and Case Management Approach for Enhancing Retention in HIV Care and Treatment Among Recipients of Care in Malawi
Published February 2024
Topics:
Advanced HIV Disease (AHD)
Countries:
Malawi
Project Brief
Spotlight on the Advanced HIV Disease (AHD) Quality Improvement Evaluation Dissemination Conference
Published February 2024
Topics:
Advanced HIV Disease (AHD)
Countries:
Malawi