Advanced HIV Disease

Overview

Despite the tremendous progress in the global fight against HIV and AIDS, including the declining incidence of HIV transmission and expanded access to antiretroviral therapy (ART), decline in AIDS-related deaths have plateaued in recent years. Up to half of the people living with HIV continue to present to care with advanced HIV disease (AHD), and individuals with AHD are at a high risk of death, even after starting ART. Those with AHD are more prone to opportunistic infections, including TB, severe bacterial infections, and cryptococcal meningitis. They also face an increased risk of morbidity and mortality.

The World Health Organization (WHO) defines AHD for adults, adolescents, and children five years and older as having a CD4 count of less than 200 cells/mm3 or meeting the criteria for WHO stage 3 or 4 disease. All children under age five are considered to have AHD. AHD includes individuals newly diagnosed with HIV, people who have treatment failure and a consequent decline in CD4 cell count, and individuals who previously initiated ART and are re-engaging with care after treatment interruption. Each of these groups highlight failures in the global response across the HIV disease cascade from prevention and early diagnosis to proper treatment and retention in care.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) is a proven leader in the global fight against HIV and AIDS. EGPAF
envisions a world where no other mother, child, or family is devastated by the disease. As part of this commitment, EGPAF has recognized the significant burden of AHD and the need for tailored approaches to meet the unique needs of people living with AHD.