AIDS-defining clinical condition

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AIDS-defining clinical conditions (aka AIDS defining illnesses or AIDS defining disease) are the terms given to a list of diseases published by the United States government-run Centers for Disease Control and Prevention (CDC) that are associated with AIDS, yet are used worldwide as a guideline for AIDS diagnosis. CDC exclusively uses the term AIDS-defining clinical conditions yet the other terms remain in common use, the words pertaining to the subject are AIDS-defining with or without a dash.

This list governs the U.S. 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[edit]

According to the CDC definition, a patient has AIDS if he or she is infected with HIV and either:

  • has a CD4+ T-cell count below 200 cells/µL;
  • or has a CD4+ T-cell percentage of total lymphocytes of less than 15%;
  • or has one of the defining illnesses.

A patient presenting with 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 either:

Conditions[edit]

1987 definition[edit]

  1. Candidiasis of bronchi, trachea, or lungs
  2. Candidiasis esophageal
  3. Coccidioidomycosis, disseminated or extrapulmonary
  4. Cryptococcosis, extrapulmonary
  5. Cryptosporidiosis, chronic intestinal for longer than 1 month
  6. Cytomegalovirus disease (other than liver, spleen or lymph nodes)
  7. Cytomegalovirus retinitis (with loss of vision)
  8. Encephalopathy (HIV-related)
  9. Herpes simplex: chronic ulcer(s) (for more than 1 month); or bronchitis, pneumonitis, or esophagitis
  10. Histoplasmosis, disseminated or extrapulmonary
  11. Isosporiasis, chronic intestinal (for more than 1 month)
  12. Kaposi's sarcoma
  13. Lymphoma, Burkitt's
  14. Lymphoma, immunoblastic (or equivalent term)
  15. Lymphoma, primary, of brain
  16. Mycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonary
  17. Mycobacterium, other species, disseminated or extrapulmonary
  18. Mycobacterium tuberculosis, any site (extrapulmonary)
  19. Pneumocystis jirovecii pneumonia (formerly Pneumocystis carinii)
  20. Progressive multifocal leukoencephalopathy
  21. Salmonella septicemia (recurrent)
  22. Toxoplasmosis of the brain
  23. Tuberculosis, disseminated
  24. Wasting syndrome due to HIV

Added in 1993[edit]

  1. Cervical cancer (invasive)
  2. Mycobacterium tuberculosis, any site (pulmonary)
  3. Pneumonia (recurrent)

Children < 13 years[edit]

Additional conditions are included for children less than 13:[1]

Dominant cause[edit]

Cryptococcosis causing fungi C. gattii and C. neoformans are found in California trees (and soil),[2] among other parts of the globe, and is said to be responsible for 60-70% of all AIDS defining illness.[3]

History[edit]

In 1993, the CDC added pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer[4] to the list of clinical conditions in the AIDS surveillance case definition published in 1987[5] and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of less 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.[6]

References[edit]

  1. ^ 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. 
  2. ^ http://www.scpr.org/news/2014/08/22/46194/california-trees-nailed-as-the-source-of-mystery-i/
  3. ^ http://emedicine.medscape.com/article/1167389-overview
  4. ^ CDC. 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults
  5. ^ "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. 
  6. ^ Lee N (April 2008). "Penicilliosis: an AIDS-defining disease in Asia". Hong Kong Med J 14 (2): 88–9. PMID 18382013. 

External links[edit]

  • 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.  edit