Clinical markers

Several studies have shown that unintentional weight loss can predict worse survival even before a first diagnosis of AIDS. See subsections on Weight loss and Wasting syndrome.

Conversely, weight gain within six months of starting antiretroviral therapy is associated with better survival and improved clinical outcomes, in particular among severely malnourished individuals. A study in Zambia, Malawi and Tanzania found that failure to gain weight six months after the start of antiretroviral therapy (ART) increased the chance of death tenfold when compared with those who had gained over ten kilogrammes. Weight gain of at least five kilogrammes meant better outcomes than no weight gain at all.¹

Not unexpectedly, the conditions of HIV disease have prognostic importance as they are directly related to the severity of immune deficiency. The presence of oral Candida (thrush) increases the risk of developing AIDS. AIDS conditions can predict the future risk of not surviving even if the AIDS conditions can be treated. In terms of the relative risk of death, one study has estimated the ranking of several conditions as (in decreasing order): PML (progressive multifocal leukoencephalopathy), lymphoma, Kaposi's sarcoma of internal organs, HIV-associated dementia, toxoplasmosis, Mycobacterium avium intracellulare (MAI), and cytomegalovirus (CMV) disease.

Severe illness and the number of symptoms experienced directly after acquiring HIV infection seems to predict a worse risk of disease progression. Fever which lasts more than seven days is a particularly strong predictor of rapid progression to AIDS. See subsection Seroconversion illness in The immune system and HIV for further information.