WHO guidelines on the management of advanced HIV disease

These guidelines provide updated WHO recommendations for the management of advanced HIV disease, integrating guidance issued between 2021 and 2025 into a consolidated publication. The document addresses the continuing burden of advanced HIV disease as a major cause of AIDS-related morbidity and mortality despite expanded access to antiretroviral therapy (ART). It outlines evidence-informed approaches for identifying advanced HIV disease, strengthening inpatient and outpatient care, and improving the prevention, diagnosis and treatment of major opportunistic infections and related conditions.

The publication presents recommendations on CD4 testing and WHO clinical staging for identifying advanced HIV disease, implementation of a package of care including rapid ART initiation and intensified adherence support, and interventions to support transitions from hospital to outpatient care. It also provides updated guidance on the management of cryptococcal disease, histoplasmosis, tuberculosis, severe bacterial infections and Kaposi’s sarcoma, together with considerations related to monitoring, palliative care and drug–drug interactions. The guidelines are intended to support national HIV programmes, clinicians and policy-makers in improving service delivery, reducing mortality and strengthening integrated, person-centred HIV care in resource-limited settings.