The prognosis of adults in the developed world with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) who are adherent with combination antiretroviral therapy (cART) is now approaching that of the general population. This is attributable to the decreased incidence of AIDS opportunistic infections (OI) from cART use and improved care for those with HIV related complications.
Thus, an increased proportion of deaths in HIV patients are due to organ failure; non-AIDS malignancies; substance abuse; and limitations in health care access.
Palliative care eligibility
• Absence of cART therapy
• Decreased performance status (Palliative Performance Scale <50%)
• A CD4+ count <25 cells/mcL, and
• A viral load >100,000 copies/mL plus either CNS lymphoma, AIDS wasting syndrome (>10% weight loss not attributable to another condition); mycobacterium avium complex; progressive multifocal leukoencephalopathy; systemic lymphoma; visceral Kaposi’s sarcoma, renal failure in the absence of dialysis, cryptosporidium infection, or toxoplasmosis.
See reference for more information about prognostic data for opportunistic infections.