| HIV disease |
| Patients will be considered to be in the terminal stage of their illness (life expectancy of 6 months or less) if they meet the following criteria (1 and 2 should be present; factors from 3 will add supporting documentation): |
- CD4 count <25 cells per microliter or persistent (2 or more assays at least 1 month apart) viral load >100,000 copies/mL, plus one of the following:
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- CNS lymphoma, untreated or persistent despite treatment
- Wasting (loss of at least 10% lean body mass)
- MAC bacteremia, untreated, unresponsive to treatment, or treatment refused
- Progressive multifocal leukoencephalopathy
- Systemic lymphoma, with advanced HIV disease and partial response to chemotherapy
- Visceral Kaposi sarcoma, unresponsive to therapy
- Renal failure in the absence of dialysis
- Cryptosporidium infection
- Toxoplasmosis, unresponsive to therapy
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- Decreased performance status, as measured by the Karnofsky Performance Status (KPS) scale, ≤50%.
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- Documentation of the following factors will support eligibility for hospice care:
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- Chronic persistent diarrhea for 1 year
- Persistent serum albumin <2.5 g/dL
- Concomitant, active substance abuse
- Age >50 years
- Absence of or resistance to effective antiretroviral, chemotherapeutic, and prophylactic drug therapy related specifically to HIV disease
- Advanced AIDS dementia complex
- Toxoplasmosis
- Congestive heart failure, symptomatic at rest
- Advanced liver disease
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