Serious bacterial infections, multiple or recurrent (i.e., any combination of at least two culture-confirmed infections within a 2-year period), of the following types: septicemia, pneumonia, meningitis, bone or joint infection, or abscess of an internal organ or body cavity (excluding otitis media, superficial skin or mucosal abscesses, and indwelling catheter-related infections) Candidiasis, esophageal or pulmonary (bronchi, trachea, lungs)
Coccidioidomycosis, disseminated (at site other than or in addition to lungs or cervical or hilar lymph nodes)
Cryptococcosis, extrapulmonary
Cryptosporidiosis or isosporiasis with diarrhea persisting >1 month
Cytomegalovirus disease with onset of symptoms before the age of 1 month (other than liver, spleen, or lymph nodes)
Encephalopathy (at least one progressive deficit present for at least 2 months in the absence of a concurrent illness): (a) failure to attain or loss of developmental milestones/intellectual ability, verified by standard scale or tests; (b) impaired brain growth or acquired microcephaly; (c) acquired symmetric motor deficit manifested by two or more of the following: paresis, pathologic reflexes, ataxia, or gait disturbance
Herpes simplex virus infection (mucocutaneous ulcer persisting for >1 month; bronchitis, pneumonitis, or esophagitis affecting a child younger than 1 month of age
Histoplasmosis, disseminated (other than or in addition to lungs or cervical or hilar lymph nodes) Kaposi sarcoma
Lymphoma (primary tumor, in brain; Burkitt lymphoma; immunoblastic or large cell lymphoma of B cell or unknown immunologic phenotype)
Mycobacterium tuberculosis, disseminated or extrapulmonary
Mycobacterium, other species or unidentified species, disseminated (other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
Mycobacterium avium complex or Mycobacterium kansasii, disseminated (other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
Salmonella (nontyphoid) septicemia, recurrent
Toxoplasmosis of the brain with onset before the age of 1 month
Wasting syndrome in the absence of a concurrent illness could explain the following findings: (a) persistent weight loss >10% of baseline or (b) downward crossing of at least two percentile lines on the weight-for-age chart or (c) below the 5th percentile on the weight-for-height chart on two consecutive measurements, ≥30 days apart, plus (1) chronic diarrhea (i.e., two or more loose stools per day for >30 days) or (2) documented fever (for ≥30 days, intermittent or constant)
From the Working Group on Antiretroviral Therapy and Medical Management of HIV-infected Children: Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Department of Health and Human Services. February 23, 2009. Available at http://aidsinfo.nih.gov/contentfiles/PediatricGuidelines.pdf . Updated from Centers for Disease Control and Prevention: 1994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age, MMWR 43(RR-12):1–10, 1994.
HIV, Human immunodeficiency virus infection; HSV, herpes simplex virus; LIP, lymphoid interstitial pneumonia.
<12 months • Regardless of clinical Treat symptoms, immune status, or viral load