HIV DISEASE

The patient has:

• CD4 + Count < 25 cells/mcL or
• Persistent viral load > 100,000 copies/ ml plus
• CNS Lymphoma
• Wasting (loss of 33%lean body mass), untreated, or not responsive to treatment
• Mycobacterium avium complex (MAC) bactermia, untreated, unresponsive to treatment, or treatment refused
• Progressive multifocal leukoenecephalopathy
• 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, systematic at rest

A physician may determine that a patient has a life expectancy of six months or less even if the above findings are not present. Co-morbidities also support eligibility for hospice care.