Patients with advanced HIV disease have a high risk of mortality, mainly from tuberculosis and cryptococcal meningitis. The advanced HIV disease management package recommended by WHO, which includes diagnostics, therapeutics, and patient psychosocial support, is barely implemented in many different countries. Here, we present a framework for the implementation of advanced HIV disease diagnostics. Laboratory and point-of-care-based reflex testing, coupled with provider-initiated requested testing, for cryptococcal antigen and urinary Mycobacterium tuberculosis lipoarabinomannan antigen, should be done for all patients with CD4⁺ cell counts of 200 cells per μL or less. Implementation of the advanced HIV disease package should be encouraged within primary health-care facilities and task shifting of testing to lay cadres could facilitate access to rapid results. Implementation of differentiated antiretroviral therapy delivery models can allow clinicians enough time to focus on the management of patients with advanced HIV disease. Efficient up-referral and post-discharge systems, including the development of patient-centric advanced HIV disease literacy, are also crucial. Implementation of the advanced HIV disease package is feasible at all health-care levels, and it should be part of the core of the global response towards ending AIDS as a public health threat.

患有晚期HIV疾病的患者有很高的死亡风险，主要是由结核病和隐球菌性脑膜炎引起的。世卫组织建议的包括诊断，治疗和患者心理支持在内的高级艾滋病毒管理一揽子计划在许多不同国家几乎没有得到实施。在这里，我们介绍了用于实施高级HIV疾病诊断的框架。对于所有患有CD4 ^+的患者，应进行针对隐球菌抗原和尿结核分枝杆菌脂阿拉伯甘露聚糖抗原的基于实验室和即时护理的反射测试，以及提供者发起的要求的测试。每微升或更少200个细胞的细胞计数。应当鼓励在初级卫生保健机构内实施艾滋病毒/艾滋病高级一揽子计划，并且将测试任务转移到下岗干部上，可以促进快速取得成果。实施差异化的抗逆转录病毒疗法交付模型可以使临床医生有足够的时间专注于晚期HIV疾病患者的治疗。有效的上转诊和出院后系统，包括发展以患者为中心的高级HIV疾病素养也至关重要。先进的艾滋病毒一揽子措施的实施在所有卫生保健水平上都是可行的，它应成为全球对付艾滋病的核心内容之一，以消除艾滋病作为一种公共卫生威胁。