Human Immunodeficiency Virus (HIV)
Patients will be considered to be in the terminal stage of their illness if they meet the following criteria: 1 should be present; factors from 2 will lend supporting documentation:
- CD4+ count <25 cells/mcl or persistent (2 or more assays at least one month apart) viral load>100,000 copies/ml, plus one of the following:
- •CNS lymphoma.
- • Untreated, or persistent despite treatment, wasting (loss of at least 10% lean body mass).
- • Mycobacterium avium complex (MAC) bacteremia, untreated, unresponsive to treatment or treatment refused.
- • Progressive multifocal leukoencephalopathy.
- • Systemic lymphoma, with advanced HIV and partial response to chemotherapy.
- • Visceral Kaposi Sarcoma unresponsive to therapy.
- • Renal failure in the absence of dialysis.
- • Cryptosporidium infection.
- • Toxoplasmosis, unresponsive to therapy.
- Documentation of the following factors will support eligibility for hospice care:
- • Chronic persistent diarrhea for one year.
- • Persistent serum albumin < 2.5.
- • Concomitant, active substance abuse.
- • Age >50 years.
- • Absence of, or resistance to, effective antiretroviral, chemotherapeutic and prophylactic drug therapy related specifically to HIV.
- • Advanced AIDS dementia complex.
- • Congestive heart failure, symptomatic at rest.
- • Advanced liver disease.