HIV Disease

The patient has:

• CD4 + Count < 25 cells/mcL or
• Persistent viral load > 100,000 copies/ ml plus
• At least one of the following:
  • CNS Lymphoma
  • Wasting (loss of 33% lean body mass), untreated, or not responsive to treatment
  • Mycobacterium avium complex (MAC) bacteremia, untreated, unresponsive to treatment, or treatment refused
  • Progressive multifocal leukoencephalopathy
  • Systemic lymphoma
  • Visceral Kaposi’s sarcoma unresponsive to therapy
  • Renal failure in the absence of dialysis
  • Cryptosporidium infection
  • Toxoplasmosis, unresponsive to therapy
  • Karnofsky Performance Status (KPS) < 50%
  • Advanced AIDS dementia complex

Supporting documentation:

• Chronic persistent diarrhea for one year
• Persistent serum albumin < 2.5
• Concomitant, active substance abuse
• Age > 50 years
• Absence of antiretroviral, chemotherapeutic and prophylactic drug therapy related specifically to HIV disease
• Congestive heart failure