AIDS-defining clinical condition
AIDS-defining clinical conditions (aka AIDS-defining illnesses or AIDS-defining diseases) is the list of diseases published by the Centers for Disease Control and Prevention (CDC) that are associated with AIDS, and used worldwide as a guideline for AIDS diagnosis. CDC exclusively uses the term AIDS-defining clinical conditions, but the other terms remain in common use.
This list governs the US government classification of HIV disease. This is to allow the government to handle epidemic statistics and define who receives US government assistance. However, considerable variation exists in the relative risk of death following different AIDS defining clinical conditions.
Definition
According to the CDC definition, a patient has AIDS if they are infected with HIV and have either:
- a CD4+ T-cell count below 200 cells/µL
- a CD4+ T-cell percentage of total lymphocytes of less than 15%
- or one of the defining illnesses.
A patient presenting one of the above conditions but with laboratory evidence against HIV infection is not normally considered to have AIDS, but an AIDS diagnosis may be given if the patient has had Pneumocystis jiroveci pneumonia, and has either:
- not undergone high-dose corticoid therapy or other immunosuppressive/cytotoxic therapy in the three months before the onset of the indicator disease
- been diagnosed with Hodgkin's disease, Non-Hodgkin's lymphoma, lymphocytic leukemia, multiple myeloma, or any cancer of lymphoreticular or histiocytic tissue, or angioimmunoblastic lymphoadenopathy
- or been diagnosed with a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia.
Defining Illnesses
1987 definition
- Candidiasis of bronchi, trachea, or lungs
- Candidiasis esophageal
- Coccidioidomycosis, disseminated or extrapulmonary
- Cryptococcosis, extrapulmonary
- Cryptosporidiosis, chronic intestinal for longer than 1 month
- Cytomegalovirus disease (other than liver, spleen or lymph nodes)
- Cytomegalovirus retinitis (with loss of vision)
- Encephalopathy (HIV-related)
- Herpes simplex: chronic ulcer(s) (for more than 1 month); or bronchitis, pneumonitis, or esophagitis
- Histoplasmosis, disseminated or extrapulmonary
- Isosporiasis, chronic intestinal (for more than 1 month)
- Kaposi's sarcoma
- Lymphoma, Burkitt's
- Lymphoma, immunoblastic (or equivalent term)
- Lymphoma, primary, of brain
- Mycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonary
- Mycobacterium, other species, disseminated or extrapulmonary
- Mycobacterium tuberculosis, any site (extrapulmonary)
- Pneumocystis jirovecii pneumonia (formerly Pneumocystis carinii)
- Progressive multifocal leukoencephalopathy
- Salmonella septicemia (recurrent)
- Toxoplasmosis of the brain
- Tuberculosis, disseminated
- Wasting syndrome due to HIV
Added in 1993
- Cervical cancer (invasive)
- Mycobacterium tuberculosis, any site (pulmonary)
- Pneumonia (recurrent)
Children < 13 years
Additional conditions are included for children younger than 13:[1]
- Bacterial infections, multiple or recurrent
- Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex
History
In 1993, the CDC added pulmonary tuberculosis, recurrent pneumonia and invasive cervical cancer[2] to the list of clinical conditions in the AIDS surveillance case definition published in 1987[3] and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of fewer than 200 cells/μL or a CD4+ percentage of less than 14. Outside the US, however, diagnosis with a listed opportunistic infection is still required.
It has been suggested that other conditions (such as penicilliosis) should be included in other countries.[4]
References
- ↑ Schneider E, Whitmore S, Glynn KM, Dominguez K, Mitsch A, McKenna MT (December 2008). "Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years--United States, 2008". MMWR Recomm Rep. 57 (RR-10): 1–12. PMID 19052530.
- ↑ CDC. 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults
- ↑ "Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. Council of State and Territorial Epidemiologists; AIDS Program, Center for Infectious Diseases". MMWR Morb. Mortal. Wkly. Rep. 36 Suppl 1: 1S–15S. August 1987. PMID 3039334.
- ↑ Lee N (April 2008). "Penicilliosis: an AIDS-defining disease in Asia". Hong Kong Med J. 14 (2): 88–9. PMID 18382013.
External links
- AIDS info
- Petruckevitch, A.; Amo, J.; Phillips, A. N.; Johnson, A. M.; Stephenson, J.; Desmond, N.; Hanscheid, T.; Low, N.; Newell, A.; Obasi, A.; Paine, K.; Pym, A.; Theodore, C.; De Cock, K. M. (1998). "Disease progression and survival following specific AIDS-defining conditions: A retrospective cohort study of 2048 HIV-infected persons in London". AIDS (London, England). 12 (9): 1007–1013. doi:10.1097/00002030-199809000-00007. PMID 9662196.