Adult Immuno-Deficiency Syndrome Medical criteria for the terminal diagnosis of HIV disease are met if the patient has BOTH 1 and 2, with 3 providing supporting documentation, but not required:. 1.CD4+ Count <25 cells/mcL or persistent viral load>100,000 copies/ml:
AND ONE OF THE FOLLOWING: a. CNS lymphoma
b. Untreated, or not responsive to treatment, wasting (loss of
         33% lean body mass)
c. Mycobacterium avium complex (MAC) bacteremia, untreated,
         unresponsive to treatment, or treatment refused
d. Progressive multifocal leukoencephalopathy
e. Systemic lymphoma, with advanced HIV disease and partial
         response to chemotherapy
f. Visceral Kaposi’s sarcoma unresponsive to therapy
g. Renal failure in the absence of dialysis
h. Cryptosporidium infection
i.  Toxoplasmosis, unresponsive to therapy
AND 2.Decreased performance status, as measured by the Karnofsky Performance Status (KPS) scale, of 50 or less 3.Documentation of the following factors will support eligibility for hospice care: a. Chronic persistent diarrhea for one year
b. Persistent serum albumin <2.5
c. Concomitant substance abuse
d. Age >50 years
e. Absence of antiretroviral, chemotherapeutic and prophylactic
         drug therapy related specifically to HIV disease
f. Advanced AIDS dementia complex
g. Congestive heart failure, symptomatic at rest
h. Chronic persistent diarrhea
If a patient meets the medical criteria above, they are by definition eligible to receive hospice services. Some patients may not meet the criteria, but may still be eligible for hospice care due to comorbidities or rapid functional decline. Contact your Samaritan Care Hospice Consultant for further information.