21.4.5  HIV wasting syndrome

A syndrome is actually not an opportunistic infection, but a clinical presentation in patients consisting of specific signs and symptoms.

  • Can you recall an example of a syndrome?

  • Acquired immunodeficiency syndrome, or AIDS.

As the disease progresses, the immune system of PLHIV is increasingly weakened, and this is associated with a gradual loss of weight. At WHO clinical stage 4, HIV wasting syndrome is characterised by an extreme loss of weight (more than 10%), associated with chronic fever and/or chronic diarrhoea. Patients presenting with HIV wasting syndrome require urgent clinical treatment and care, and should be urgently referred to the nearest health centre.

  • A 32-year-old person living with HIV comes to your health post with unexplained weight loss of 7 kg. His normal weight was 60 kg, but he doesn’t complain of other health problems. How do you explain his weight loss in terms of WHO HIV clinical staging?

  • Weight loss is one sign used in WHO HIV clinical staging. In this case, the patient has lost 7 kg, which is 11.6% (7 x 100/60) of his normal body weight. Losing more than 10% of normal body weight will immediately put him at WHO clinical stage 3. This patient might have other opportunistic infections that he is not aware of, and he needs to be referred to the health centre for further investigation.

21.4.4  Pulmonary tuberculosis (PTB)

21.5  Opportunistic infections and provider-initiated counselling and testing