A third of new HIV diagnoses in Kenya are already at advanced stages, indicating the onset of AIDS, where patients face extremely high risks of opportunistic infections and death.
Dr. Lazarus Momanyi, a technical assistant at the National AIDS and STIs Control Programme, highlighted that men are disproportionately affected due to their reluctance to seek medical help until they are seriously ill.
“Individuals with advanced HIV often come for care only when their CD4 cell counts are very low, significantly increasing their risk of disease progression, opportunistic infections, and death,” Dr. Momanyi explained.
Advanced HIV disease (AHD) is defined by a CD4 cell count below 200 cells/mm³ or the presence of severe clinical symptoms categorized as WHO stage 3 or 4, indicative of AIDS. Common severe conditions associated with AHD include tuberculosis, severe bacterial infections, and cryptococcal meningitis.
Patients with AHD include those new to antiretroviral therapy (ART), those who have interrupted their treatment, and those experiencing treatment failure.
“For adults and children over five, AHD is identified as a CD4 count below 200 cells/mm³ or WHO stage 3 or 4 symptoms. This includes both ART-naïve individuals and those who have interrupted treatment. Children under five with HIV are automatically classified as having AHD, except those who have been stable on treatment for over a year,” Dr. Momanyi said.
To address the growing number of AHD cases, 140 health facilities across Kenya have been designated to provide comprehensive care. These hospitals are equipped to manage critically ill AHD patients with trained medical personnel and advanced diagnostic facilities.
“These centers will serve as referral sites for hospitalized patients and those needing regular monitoring, including treatment for cryptococcal meningitis,” Dr. Momanyi added.
Dr. Momanyi spoke during a meeting organized by the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK), aimed at engaging journalists, experts, and communities on supporting individuals with HIV and AHD. The event was part of NEPHAK’s advocacy efforts, supported by the Global Network of People Living with HIV, focusing on sexual and reproductive health, human rights, and empowerment.
NEPHAK Chairperson Nelson Otwoma noted that the increase in advanced HIV cases is reversing progress Kenya had made in nearly eliminating advanced HIV. He emphasized the need for men to seek testing and treatment earlier to avoid severe immune system compromise.
The WHO recommends a comprehensive approach, including screening, treatment, prophylaxis for opportunistic infections, rapid ART initiation, and improved adherence support.
Dr. Momanyi stressed the urgent need for improved early detection and diagnosis of AHD through effective screening, with a new implementation plan for AHD currently being developed to guide healthcare workers in providing necessary screenings, treatments, and referrals.
