PHAN LOAI GIAI DOAN LAM SANG NHIEM HIV/AIDS O TRE EM

Lam sang Giai doan I

- Khong trieu chung.

- Sung hach lympho toan than

- Gan lach to

Lam sang Giai doan II

- Nhiem trung duong ho hap tren tai dien hoac man tinh (viem tai giua, chay mu tai, viem xoang, mac tu 2 lan tro len trong khoang thoi gian 6 thang bat ky).

- Phat ban san ngua.

- Herpes zoster (mac tu 1 dot tro len trong vong 6 thang).

- Loet mieng tai dien (mac tu 2 dot tro len trong vong 6 thang).

- Do vien loi.

- Loet khoe mieng.

- Sung tuyen mang tai.

- Viem da tuyen ba.

- Nhem vius gay u nhu o nguoi hoac virus u mem lay nang (tren 5% dien tich co the hoac gay bien dang).

- Nhiem nam mong.

Lam sang giai doan III:

- Suy dinh duong muc do vua* khong dap ung thich hop voi dieu tri thong thuong.

- Tieu chay keo dai > 30 ngay ma khong thay can nguyen ro nguyen nhan nao khac (> 14 ngay).

- Sot keo dai khong ro nguyen nhan (sot cach quang hoac lien tuc tren 1 thang).

- Nhiem nam candida to mieng (ngoai giai doan chu sinh).

- Bach san dang long o mieng.

- Lao phoi**.

- Viem phoi nang tai dien duoc cho la do vi khuan (mac tu 2 lan tro len trong vong 6 thang).

- Viem loet hoai tu loi cap tinh loi/viem quanh cuong rang.

- Viem phoi ke tham nhiem lympho.

- Thieu mau (< 80g/L), ha bach cau trung tinh (< 1000/mm3) hoac ha tieu cau (< 30000/mm3) khong ro nguyen nhan.

- Benh ly phoi man tinh lien quan den HIV, bao gom ca gian phe quan.

- Benh ly co tim lien quan den HIV hoac benh ly than lien quan den HIV.

Lam sang Giai doan IV

Cac benh canh co the chan doan so bo tren co so cac dau hieu lam sang hoac cac tham do don gian:

- Suy mon nang*** hoac suy dinh duong nang khong ro nguyen nhan khong dap ung thich hop voi dieu tri thong thuong.

- Viem phoi do pneumocystis (PCP).

- Nhiem trung nang tai dien duoc cho la do vi khuan (mac tu 2 dot tro len trong vong 1 nam, nhu viem mu mang phoi, viem mu co, nhiem trung xuong hoac khop, viem mang nao, nhung khong bao gom viem phoi).

- Nhiem Herpes simplex moi-mieng hoac o da man tinh (keo dai tren 1 thang).

- Lao ngoai phoi.

-  Sarcoma Kaposi.

- Nhiem nam candida thuc quan.

- Benh do toxoplasma he TKTU.

- Benh ly nao do HIV.

Cac benh canh can xet nghiem khang dinh chan doan:

- Benh do CMV (viem vong mac do CMV, hoac benh do CMV o cac co quan ngoai gan lach hoac hach lympho, khoi phat tu 1 thang tuoi).

- Viem mang nao do cryptococcus (hoac benh do cryptococcus ngoai phoi).

- Benh nam lan toa do loai nam l­u hanh tai dia phuong (nhu benh nhiem nam histoplasma ngoai phoi, benh nhiem nam coccidio, penicillium).

- Benh do cryptosporidia.

- Benh do isospora.

- Benh lan toa do cac loai mycobacteria khong phai lao.

- Nhiem nam candida khi quan, phe quan hoac phoi.

- Ro truc trang-bang quang mac phai do HIV.

- U lympho o nao hoac u lympho khong phai Hodgkin te bao B.

- Benh ly nao chat trang da o tien trien.

Chan doan lam sang giai doan IV o tre < 18 thang khong co xet nghiem virus hoc

Tre co huyet thanh HIV (+) va co ≥ 2 benh chi diem sau day:

- Nam candida hong.

- Viem phoi nang.

- Suy mon/suy dinh duong nang.

- Nhiem khuan huyet nang.

------------------------------

* Can nang rat thap so voi lua tuoi.

** Lao co the xuat hien voi bat cu so TCD4 nao. Can xem xet ty le % TCD4, neu co.

*** Trong luong co the rat thap hoac suy mon nang co the nhin thay hoac phu ca hai chan.