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WS 293-2019 English PDF

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WS 293-2019: Diagnosis for HIV/AIDS
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WS 293: Evolution and historical versions

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WS 293-2019English459 Add to Cart 4 days [Need to translate] Diagnosis for HIV/AIDS Valid WS 293-2019
WS/T 293-2019English439 Add to Cart 4 days [Need to translate] (AIDS and HIV infection diagnosis) WS/T 293-2019
WS 293-2018EnglishRFQ ASK 3 days [Need to translate] Diagnosis for HIV／AIDS WS 293-2018
WS 293-2008English759 Add to Cart 4 days [Need to translate] Diagnostic criteria for HIV/AIDS Obsolete WS 293-2008

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Standard similar to WS 293-2019

GB 15979   GB/T 15981   WS/T 641   WS/T 283   WS 283   

Basic data

Standard ID WS 293-2019 (WS293-2019)
Description (Translated English) Diagnosis for HIV/AIDS
Sector / Industry Health Industry Standard
Classification of Chinese Standard C59
Classification of International Standard 11.020
Word Count Estimation 20,266
Date of Issue 2019
Date of Implementation 2019-07-01
Issuing agency(ies) National Health Commission

WS 293-2019: Diagnosis for HIV/AIDS

---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Diagnosis for HIV/AIDS ICS 11.020 C 59 WS People's Republic of China Health Industry Standard Replacing WS 293-2008 AIDS and HIV infection diagnosis Diagnosis for HIV/AIDS Published on.2019 - 01 - 02 2019 - 07 - 01 implementation National Health and Wellness Committee of the People's Republic of China

Foreword

Chapter 6 of this standard is mandatory and the rest are recommended. This standard was drafted in accordance with the rules given in GB/T 1.1-2009. This standard replaces WS 293-2008 Diagnostic Criteria for AIDS and HIV Infection. Compared with WS 293-2008, the main technical changes of this standard are as follows. - Revised the definition of the term "HIV-infected person" (see 2.3,.2008 edition 2.3) - Removed the term "latency period" "S/CO value" (see 2.5, 2.12 of the.2008 edition); -- Revised the term "seroconversion" to "HIV serum antibody positive" (see 2.7,.2008 edition 2.8) - Revised the definition of the term "window period" (see 2.8, 2.9 of the.2008 edition); - Revised the definition of the term "HIV antibody screening test" (see 2.10, 2.11 of the.2008 edition); -- Revised the term "HIV antibody confirmation test" as "HIV supplementation test" and definition (see 2.11,.2008 version 2.13); - Added the term "CD4 T lymphocyte count" "Percentage of CD4 T lymphocytes" (see 2.12, 2.13); - Removed the term "highly active antiretroviral therapy" (see 2.14 of the.2008 edition); - Revised the term "history of iatrogenic infection" as "historic exposure history" (see 2.15 and 4.1.4,.2008 editions 2.21 and 4.1.4); -- Removed the term "clinical manifestations" and modified the term "HIV encephalopathy" to "HIV-related neurological symptoms" and related The definition of bed symptoms is moved to Appendix A (see A.1~A.5 in Appendix A, 2.15~2.19, 2.22 in.2008); - Added abbreviations CPs, VL (see Chapter 3); -- Removed the acronym HAART (see Chapter 3); -- Revised the clinical manifestations of HIV infection and moved the specific description to Appendix A (see.2008 edition 4.2); - Revised the description of serological test results from "positive"/"negative" to "reactive"/"no response" (see 4.3.2.1, 4.3.1 of the.2008 edition); -- Revised HIV nucleic acid test "positive test results" as "positive nucleic acid qualitative test results or quantitative test > 5 000 CPs/mL" (See 4.3.3.2, 4.3.2.2 of the.2008 edition); - Revised "CD4 cell test" as "immunological test" (see 4.3.4,.2008 version 4.3.3); -- Revised the diagnostic criteria for HIV-infected persons. "Adults and young people aged 15 or older (including 15 years old)" as "adults, adolescents and 18" "Children over the age of one month", "Children under the age of 15" are "children 18 months of age and younger" and have revised the diagnostic criteria. Incorporate nucleic acid testing into diagnostic criteria (see 6.1, 6.1 of the.2008 edition); -- Revised "Clinical Staging of HIV/AIDS" (see Chapter 7, Chapter 7 of the.2008 edition); - Increased the clinical manifestations of HIV infection in Appendix A; -- Revised Appendix B (see Appendix A of the.2008 edition). This standard was drafted. China Center for Disease Control and Prevention, STD/AIDS Prevention and Control Center, Peking Union Medical College Hospital, China Medical University, Shanghai Municipal Center for Disease Control and Prevention, Military Medical Research Institute of the Chinese People's Liberation Army Academy of Military Sciences, and Beijing Ditan Medical College affiliated to Capital Medical University Hospital, Beijing You'an Hospital, Capital Medical University, China Food and Drug Control Research Institute, Yunnan Provincial Center for Disease Control and Prevention, National Health Health Commission Clinical Laboratory Center, Guangzhou Eighth People's Hospital, Beijing Entry-Exit Inspection and Quarantine Bureau, Henan Provincial Center for Disease Control and Prevention. The main drafters of this standard. Shao Yiming, Wang Ning, Li Taisheng, Zhang Fujie, Shang Hong, Kang Laiyi, Zhong Ping, Li Jingyun, Jiang Yan, Zhao Hong Xin, Wu Hao, Wang Youchun, Jia Manhong, Wang Lunan, Cai Weiping, Zhu Hong, Wang Zhe, Xiao Yao, Liang Hua, Liao Lingjie, Mu Weiwei, Wu Yingqi. The previous versions of the standards replaced by this standard are. --WS 293-2008. AIDS and HIV infection diagnosis

1 Scope

This standard specifies the diagnostic basis, diagnostic principles, diagnosis and clinical stage of AIDS and HIV infection. This standard applies to the diagnosis of AIDS and HIV infection in various medical and health institutions and their staff at all levels across the country.

2 Terms and definitions

The following terms and definitions apply to this document. 2.1 HIV human immunodeficiency virus;HIV Human immunodeficiency virus The pathogen that causes AIDS. 2.2 AIDS acquired immunodeficiency syndrome; AIDS Acquired immunodeficiency syndrome Caused by HIV infection, a progressive immune function defect characterized by a decrease in human CD4 T lymphocytes, which may be secondary to each A comprehensive disorder of opportunistic infections, malignant tumors, and central nervous system disorders. 2.3 HIV infected person Individuals who have not progressed to the AIDS stage after HIV infection. 2.4 AIDS patient AIDS patient Patients who develop to the AIDS stage after HIV infection. 2.5 CD4 T lymphocyte CD4 positive T lymphocyte Helper T lymphocytes expressing CD4 molecules are the main target cells for HIV infection. 2.6 Opportunistic infection Infectious diseases that occur when immune function is low. 2.7 HIV serum antibody positive for HIV seroconversion The HIV antibody in the serum of the body after infection with HIV changes from no reaction to a reactive process. 2.8 Window period Infection markers such as HIV antibodies, antigens or nucleic acids in HIV-infected humans can be detected in the previous period. Note. The blood in the window period is already infectious. The window period for the detection of HIV antibodies, antigens and nucleic acids by existing diagnostic techniques is 3 weeks, 2 weeks and 1 after infection, respectively. Around the week. 2.9 Viral load The amount of HIV RNA in the patient's plasma (clear) is an indicator of the quantitative detection of HIV nucleic acid. The test results use HIV RNA per milliliter of plasma (clear). The copy number or international unit is expressed (CPs/mL or IUs/mL). 2.10 HIV antibody screening test A preliminary method for detecting the presence or absence of HIV antibodies in blood or body fluids of a human body, as well as methods for simultaneously detecting HIV antibodies and antigens. Note. The results of a reaction or no reaction of HIV antibodies or antigens were detected. Commonly used detection methods are enzyme-linked immunosorbent assay (ELISA), chemiluminescence or exemption Epidemic fluorescence test, immunoagglutination test, immunochromatographic test, immunodiafiltration test and antigen-antibody combined test. 2.11 HIV supplement test After obtaining the results of the screening test, in order to accurately determine whether to continue to detect the presence or absence of HIV antibodies or nucleic acids in the blood or body fluids of the body, Including antibody confirmation test and nucleic acid test. Note. Antibody confirmation tests include immunoblot assays, strip/linear immunoassays, immunochromatographic assays, immunodiafiltration assays, and alternative assays under specific conditions. The nucleic acid test includes a nucleic acid qualitative test and a nucleic acid quantitative test. 2.12 CD4 T lymphocyte count CD4 positive T lymphocyte count The number of CD4 T lymphocytes contained in peripheral blood per cubic millimeter (or per microliter). 2.13 CD4 Percentage of T lymphocytes CD4 positive T lymphocyte percentage Percentage of CD4 T lymphocytes in peripheral blood as a percentage of total lymphocytes. 2.14 Occupational exposure history People who work on HIV/AIDS or who may be exposed to HIV work have a history of accidental contact with HIV at work. 2.15 Nosocomial exposure history Have had a history of unsafe injection, puncture or surgery during the treatment, or have received blood, blood products, tissue without HIV testing Or the history of the organ.

3 Abbreviations

The following abbreviations apply to this document. AIDS. AIDS (acquired immunodeficiency syndrome) CPs. copy number (copies) HIV. human immunodeficiency virus PGL. persistent generalized lymphadenopathy VL. viral load (viral load)

4 diagnosis basis

4.1 Epidemiological history 4.1.1 Have a history of sexually transmitted diseases or sexually transmitted diseases. 4.1.2 There are unsafe sex (including same-sex and heterosexual contact). 4.1.3 There is a history of drug abuse in a shared syringe. 4.1.4 History of iatrogenic exposure. 4.1.5 Have a history of occupational exposure. 4.1.6 Spouse or sexual partner of an HIV/AIDS patient. 4.1.7 Children born to HIV/AIDS mothers. 4.2 Clinical manifestations (see Appendix A for various clinical manifestations) 4.2.1 Acute HIV infection syndrome (see Appendix A.1). 4.2.2 PGL (see Appendix A.2). 4.2.3 Clinical manifestations of mild defects in the immune system. a) Adults and adolescents aged 15 years and older (including 15 years old). Group A clinical manifestations (see Appendix A.6.1.1). b) Children under 15 years of age. Group D clinical presentation (see Appendix A.6.2.1). 4.2.4 Clinical manifestations of moderate to severe immune system. a) Adults and adolescents aged 15 years and older (including 15 years old). Group B clinical manifestations (see Appendix A.6.1.2). b) Children under 15 years of age. clinical manifestations of group E (see Appendix A.6.2.2). 4.2.5 Clinical manifestations of severe immune system defects, indications of AIDS, including opportunistic infections, tumors and HIV-related gods Systemic symptoms. a) Adults and adolescents aged 15 years and older (including 15 years old). clinical manifestations of group C (see Appendix A.6.1.3). b) Children under 15 years of age. clinical manifestations of group F (see Appendix A.6.2.3). 4.3 Laboratory testing (specific description of each HIV laboratory testing technology, see Appendix B) 4.3.1 General Due to the window period of detection, laboratory tests should be combined with antibody detection, nucleic acid detection and HIV virus isolation test according to the situation. 4.3.2 Serological testing (see Appendix B.1) 4.3.2.1 HIV antibody screening test The screening test results are responsive, suggesting that HIV antibodies may be positive and need to be further supplemented to confirm. Screening test results are not reversed Should, report HIV antibody negative. 4.3.2.2 HIV antibody confirmation test 4.3.2.2.1 Determination of HIV antibody confirmation test results a) HIV-1 antibody positive ( ), one of the following criteria is required. 1) At least 2 env bands (gp41 and gp160/gp120) appear, or at least 1 env band and at least 1 gag or pol Bands appear at the same time; 2) Meet the positive criteria provided by the Nationally Approved HIV Antibody Confirmation Kit. b) HIV-2 antibody positive ( ), one of the following criteria is required. 1) There are at least 2 env bands (gp36 and gp140/gp105); 2) Meet the positive criteria provided by the Nationally Approved HIV Antibody Confirmation Kit. c) HIV antibody negative (-). no specific bands of HIV antibodies appear. d) HIV antibody is uncertain (±). A specific band of HIV antibodies is present, but not enough to be positive. 4.3.2.2.2 Treatment of HIV antibody confirmation test results Confirmation test results are positive, report HIV antibody positive; confirm test results are negative, report HIV antibody negative; confirm test results are not correct It is uncertain to report HIV antibodies, and it is recommended to follow up or do HIV nucleic acid testing as soon as possible after 2 weeks to 4 weeks. 4.3.3 Pathogen detection 4.3.3.1 HIV virus isolation test (see Appendix B.2) The test results were positive for HIV infection, and negative for HIV infection. 4.3.3.2 HIV nucleic acid testing (see Appendix B.3) Positive or quantitative tests for nucleic acid qualitative test results > 5,000 CPs/mL suggest HIV infection, and negative can not rule out HIV infection. 4.3.4 Immunological testing (see Appendix B.4) 4.3.4.1 Detection classification Immunological testing is the main indicator for the staging and judgment of HIV infection and AIDS, mainly using CD4 T lymphocyte examination. Measured, divided into CD4 T lymphocyte counts and percentages. 4.3.4.2 CD4 T lymphocyte count Suitable for adults and children and adolescents over 5 years old. The population CD4 T lymphocyte count ≥ 500/mm3, suggesting no immunodeficiency; 350/mm 3～499/mm3, suggesting mild immunodeficiency;.200/mm3～349/mm3, suggesting moderate immunodeficiency; < 200/mm3, suggesting severe Immunodeficiency. 4.3.4.3 CD4 T lymphocyte percentage Suitable for children 5 years old and younger. The percentage of CD4 T lymphocytes in this population in peripheral blood T cells is >35% (< 12 months old), or >30% (12 months to 36 months), or >25% (37 months to 60 months), suggesting no immunodeficiency; 30% to 35% (< 12 months old), or 25%~ 30% (12 months to 36 months), or 20% to 25% (37 months to 60 months), suggesting mild immunodeficiency; 25% to 29% (< 12 months old), Or 20% to 24% (12 months to 36 months), or 15% to 99% (37 months to 60 months), suggesting moderate immunodeficiency; < 25% (< 12 Month age), or < 20% (12 months to 36 months) or < 15% (37 months to 60 months), suggesting severe immunodeficiency.

5 Diagnostic principles

The diagnostic principle of HIV/AIDS is based on laboratory tests, combined with clinical presentation and reference epidemiological data. HIV resistance Body and pathogen testing is the basis for the diagnosis of HIV infection; epidemiological history is an important reference for the diagnosis of acute phase and HIV infection in infants and young children; CD4 T Lymphocyte detection and clinical manifestations are the main basis for the diagnosis of HIV infection staging; indications of AIDS are an important basis for the diagnosis of AIDS.

6 diagnosis

6.1 HIV infection 6.1.1 Adults, adolescents and children over 18 months of age You can diagnose if you meet one of the following criteria. a) HIV antibody screening test is reactive and HIV antibody confirmation test is positive; b) HIV antibody screening test is reactive and nucleic acid qualitative test is positive; c) HIV antibody screening test response and nucleic acid quantification test > 5000 CPs/mL; d) have a history of epidemiology or AIDS-related clinical manifestations, both HIV nucleic acid tests are positive; e) HIV isolation test is positive. 6.1.2 Children 18 months of age and younger You can diagnose if you meet one of the following criteria. a) Both HIV-infected mothers and both HIV nucleic acid tests are positive (the second test needs to be sampled 4 weeks after birth); b) have a history of iatrogenic exposure, positive for HIV isolation test or positive for both HIV nucleic acid tests; c) Positive for HIV-infected mothers and HIV isolation test. 6.2 AIDS 6.2.1 Adults and young people aged 15 or older (including 15 years old) You can diagnose if you meet one of the following criteria. a) HIV infection and CD4 T lymphocyte count < 200/mm3; b) HIV infection and associated with at least one adult AIDS-indicating disease (see Appendix A.6.1.3). 6.2.2 Children under 15 years old You can diagnose if you meet one of the following criteria. a) HIV infection and CD4 T lymphocyte percentage < 25% (< 12 months old), or < 20% (12 months to 36 months old), or < 15% (37 months to 60 months), or CD4 T lymphocyte count < 200/mm3 (5 to 14 years old); b) HIV infection and at least one indication of AIDS in children (see Appendix A.6.2.3). 7 Clinical stage of HIV/AIDS 7.1 Adults and young people aged 15 or older (including 15 years old) 7.1.1 Stage I (early HIV infection) HIV-infected persons can be diagnosed if they meet the following criteria. a) epidemiological history and/or acute HIV infection syndrome and/or PGL within 3 months to 6 months; b) The antibody screening test has no response and both nucleic acid tests are positive; c) HIV serum antibody positives occur within one year. 7.1.2 Phase II (mid-HIV infection) HIV-infected persons can be diagnosed if they meet the following criteria. a) CD4 T lymphocyte count is.200/mm3 ~ 500/mm3; b) asymptomatic or at least one clinical manifestation in accordance with 4.2.3 a); c) at least one of the clinical manifestations in accordance with 4.2.4 a). 7.1.3 Phase III (AIDS period) HIV-infected persons can be diagnosed if they meet the following criteria. a) CD4 T lymphocyte count < 200/mm3; b) at least one clinical manifestation in accordance with 4.2.5 a). 7.1.4 The main conditions for clinical staging of adults and adolescents are shown in Table 1. Table 1 Clinical staging and staging criteria of HIV/AIDS among adults and 15 years old (including 15 years old) Clinical stage CD4 T lymphocyte Count (pieces/mm3) HIV antibody test a HIV nucleic acid test a main clinical manifestations Stage I (HIV infection) Early) >500 or a transient reduce - or ± or seroconversion Acute HIV infection syndrome, PGL or no disease Stage II (HIV is.200 to 500 early stage II asymptomatic or 4.2.3 a) Mid-dyeing) clinical manifestations Clinical manifestations of 4.2.4 a) in the late phase II Stage III (AIDS period) < 200 has at least one 4.2.5 a) clinical manifestations Note 1. This table is based on the laboratory test indicators and clinical manifestations of most HIV/AIDS patients, and does not exclude exceptions for a small number of HIV/AIDS patients. Happening. Note 2. This table is only used as a basis for judging the clinical stage of HIV/AIDS. For the diagnosis of HIV/AIDS, the indicators listed in 6.1.1 and 6.2.1 should be referred to. The results of HIV antibody and HIV nucleic acid detection are expressed as positive ( ), negative (-), and uncertain (±). 7.2 Children under 15 years old 7.2.1 Stage I (early HIV infection) HIV-infected persons can be diagnosed if they meet the following criteria. a) CD4 Percentage of T lymphocytes >35% (< 12 months old), >30% (12 months to 36 months), >25% (37 months to 60 years) Month age), CD4 T lymphocyte count ≥ 500/mm3 (≥ 5 years old); b) Have PGL or asymptomatic. 7.2.2 Phase II (middle HIV infection) HIV-infected persons can be diagnosed if they meet the following criteria. a) CD4 The percentage of T lymphocytes is 25% to 35% (< 12 months old), 20% to 30% (12 months to 36 months), 15% to 25%. (37 months to 60 months old), CD4 T lymphocyte counts ranged from.200/mm3 to 499/mm3 (≥5 years old); b) at least one clinical manifestation in accordance with 4.2.3 b); c) at least one clinical manifestation in accordance with 4.2.4 b). 7.2.3 Phase III (AIDS period) HIV-infected persons can be diagnosed if they meet the following criteria. a) CD4< 25% (< 12 months old), < 20% (12 months to 36 months), < 15% (37 months to 60 months), < 200/ Mm (≥5 years old); b) at least one clinical manifestation in accordance with 4.2.5 b). 7.2.4 The main conditions of clinical staging of children are shown in Table 2. Table 2 Clinical staging and staging criteria for HIV/AIDS in children under 15 years old Clinical stage Age-related CD4 T lymphocyte percentage/count value HIV antibody Detect a HIV nucleic acid Detect a Main clinical manifestations < 12 Month age December Age ~ 36 Month age 37 months Age ~ 60 Month age ≥5 years old /mm3 or% Stage I (HIV Early infection) >35 >30 >25 ≥500 Serum positivity or PGL or asymptomatic Phase II (HIV Mid-infection) 25～35 20～30 15～25 200~ In the early stage II, there is 4.2.3 b) Clinical manifestations In the late phase II, there is 4.2.4 b) Clinical manifestations Phase III (AIDS period) < 25 < 20 < 15 < 200 or < 15% Clinical table with 4.2.5 b) Note 1. This table is based on the laboratory test indicators and clinical manifestations of most HIV/AIDS patients, and does not exclude exceptions for a small number of HIV/AIDS patients. Happening. Note 2. This table is only used as a basis for judging the clinical stage of HIV/AIDS. For the diagnosis of HIV/AIDS, the indicators listed in 6.1 and 6.2.2 should be referred to. The results of HIV antibody and HIV nucleic acid detection are expressed as positive ( ) and negative (-). AA

Appendix A

(informative appendix) Clinical manifestations of HIV infection A.1 acute HIV infection syndrome Fever, sore throat, rash, muscle and joint pain, swollen lymph nodes, headache, diarrhea, nausea, within 1 month of initial HIV infection A group of clinical manifestations such as vomiting. A.2 persistent generalized lymphoadenopthy (PGL) Two or more lymph nodes other than the groin of the infected person with HIV for other reasons have a diameter > l cm and last for more than 3 months. A.3 HIV wasting syndrome HIV-infected or AIDS patients have a weight loss of more than 10% within six months, with persistent fever for more than 1 month, or persistent diarrhea Symptoms and signs after 1 month, poor appetite, weakness and weakness. A.4 HIV associated neurocognitive disorders Perceptions caused by HIV infection and abnormalities of motor neurons affect daily work, manifested as forgetfulness, difficulty in concentration, and thinking Dimensionality, depression, subtle motor function damage, etc. A.5 Infant HIV associated neurocognitive disorders Children infected with HIV develop one of the following symptoms for no other reason. -- brain developmental disorders or atrophy; --Mental retardation; -- Symmetrical dyskinesia; -- contempt; -- Ataxia or gait disorder. A.6 Classification of clinical manifestations of HIV infection A.6.1 Clinical manifestations of adults and adolescents aged 15 years and older (including 15 years old) are divided into group A, group B and group C. A.6.1.1 Group A clinical manifestations The clinical manifestations of this group occur when the immune system is mildly deficient, including any of the following. -- Unexplained weight loss, no more than 10% of the original weight; - recurrent upper respiratory tract infection, ≥ 2 times in the past 6 months; -- herpes zoster; -- angular cheilitis, cheilitis; - recurrent oral ulcers, ≥ 2 times in the past 6 months; -- nodular pruritus; -- seborrheic dermatitis; -- Hyperthyroidism. A.6.1.2 Group B clinical manifestations This group of clinical manifestations occurs when the immune system is moderately deficient, including any of the following. -- Unexplained weight loss, more than 10% of the original weight; - Unexplained diarrhea lasting more than one month; -- Unexplained fever, intermittent or persistent for more than 1 month; -- persistent oral Candida infection; -- oral mucosal hairy leukoplakia; - tuberculosis (current); - severe bacterial infections (eg pneumonia, body cavity or visceral abscess, purulent myositis, bone and joint infections, meningitis, bacteremia); - acute necrotizing ulcerative gingivitis, periodontitis or stomatitis; - Unexplained anemia (hemoglobin < 80 g/L) and neutropenia (neutrophil count < 0.5×109/L) or platelets Reduced (platelet count < 50×109/L) for more than 1 month. A.6.1.3 Clinical manifestations of group C The clinical manifestations of this group appear when the immune system is severely deficient, and are indicators of AIDS, including any of the following. --HIV wasting syndrome; -- Pneumocystis pneumonia; - Esophageal candidiasis; - disseminated mycosis (coccidioidomycosis or histoplasmosis); - recurrent bacterial pneumonia, ≥ 2 times in the past 6 months; -- Chronic herpes simplex virus infection (lip, genital or anorectal) for more than 1 month; - any internal organ herpes simplex virus infection; - cytomegalovirus infectious disease (except liver, spleen, lymph nodes); - extrapulmonary tuberculosis; - disseminated non-tuberculous mycobacterial disease; -- recurrent non-typhoid Salmonella sepsis; - Chronic cryptosporidiosis (with diarrhea, lasting > 1 month); -- Chronic isosporosis; - atypical disseminated leishmaniasis; -- Kaposi's sarcoma; - brain or B cell non-Hodgkin's lymphoma; -- invasive cervical cancer; -- Toxoplasma encephalopathy; -- Marniffe Penicillium; - extrapulmonary cryptococcosis, including cryptococcal meningitis; - progressive multifocal leukoencephalopathy; -- HIV-related neurocognitive disorders; -- Symptomatic HIV-associated cardiomyopathy or kidney disease. A.6.2 The clinical manifestations of children under 15 years ...

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