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{{AIDS}}
{{AIDS}}
{{CMG}} '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
{{CMG}} '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
==Overview==
==Overview==
'''AIDS defining clinical conditions''' is the terminology given to a list of diseases published by the [[United States]] government run Centers for Disease Control and Prevention ([[Centers for Disease Control and Prevention|CDC]]). This list governs the [[United States|U.S.]] government classification of HIV disease. This is to allow the government to handle epidemic statistics and define who receives US government assistance. In 1993, the CDC added pulmonary [[tuberculosis]], recurrent [[pneumonia]], and invasive [[cervical cancer]] to the list of clinical conditions in the [[AIDS]] surveillance case definition published in 1987 and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of less than 200 cells/uL or a CD4+ percentage of less than 14. Considerable variation exists in the relative risk of death following different AIDS defining clinical conditions.
AIDS is defined as an the presence of either of the following in a patient with HIV infection: a CD4+ T-cell count below 200 cells/µl, a CD4+ T-cell percentage of total lymphocytes of less than 15%, any of the 27 specified AIDS-defining illnesses.


According to the US CDC definition, you have [[AIDS]] if you are infected with HIV and present with one of the following:
==Definition==


A CD4+ T-cell count below 200 cells/µl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%)
{{#widget:BlueTable}}
{|class="BlueTable" style="width: 400px; background: #F5F5F5"
! AIDS Case Definition
|-
|style="background: #DCDCDC" |According to the CDC definition, a patient has [[AIDS]] if he or she is infected with [[HIV]] and presents with one of the following:
|-
|style="background:  #F5F5F5"|
*A CD4+ T-cell count below 200 cells/µl
|-
|'''OR'''
|-
|style="background:  #F5F5F5"|
*A CD4+ T-cell percentage of total lymphocytes of less than 15%
|-
|'''OR'''
|-
|style="background:  #F5F5F5"|
*Has one of the [[AIDS defining clinical condition#AIDS defining conditions|defining conditions]].
|-
!
|-
|style="background: #DCDCDC" |If a patient presents with one of the above conditions but with a negative HIV test, he or she will not normally be considered to have AIDS.  <br>However, an AIDS diagnosis may be given if the patient has had Pneumocystis jiroveci pneumonia, and one of the following conditions:
|-
|style="background:  #F5F5F5"|
*Has not undergone high-dose corticoid therapy or other immunosuppressive/ cytotoxic therapy in the three months before the onset of the indicator disease
|-
|'''OR'''
|-
|style="background:  #F5F5F5"|
*Has been diagnosed with Hodgkin's disease, Non-Hodgkin's lymphoma, lymphocytic leukemia, multiple myeloma, or any cancer of lymphoreticular or histiocytic tissue, orangioimmunoblastic lymphoadenopathy
|-
|'''OR'''
|-
|style="background:  #F5F5F5"|
*Has been diagnosed with a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia.
|-
|}


'''or'''
==AIDS-Defining Illnesses==
In 1993, the CDC added pulmonary [[tuberculosis]], recurrent [[pneumonia]], and invasive [[cervical cancer]] to the list of clinical conditions in the [[AIDS]] surveillance case definition published in 1987 and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of less than 200 cells/uL or a CD4+ percentage of less than 14. Considerable variation exists in the relative risk of death following different AIDS defining clinical conditions.


you have one of the following defining illnesses:
===List of AIDS-defining Illnesses===
#[[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|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 jiroveci pneumonia]] (formerly Pneumocystis carinii)
#[[Progressive multifocal leukoencephalopathy]]
#[[Salmonella]] septicemia (recurrent)
#[[Toxoplasmosis]] of the brain
#[[Tuberculosis]], disseminated
#[[wasting|Wasting syndrome due to HIV]]
#[[Cervical cancer]] (invasive)
#[[Mycobacterium tuberculosis]], any site (pulmonary)
#[[Pneumonia]] (recurrent)


*[[Candidiasis]] of bronchi, trachea, or lungs
===Children < 13 years===
*[[Candidiasis]] esophageal
Additional conditions are included for children less than 13:<ref name="pmid19052530">{{cite journal |author=Schneider E, Whitmore S, Glynn KM, Dominguez K, Mitsch A, McKenna MT |title=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 |journal=MMWR Recomm Rep |volume=57 |issue=RR-10 |pages=1–12 |year=2008 |month=December |pmid=19052530 |doi= |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a1.htm}}</ref>
*[[Cervical cancer]] (invasive)
* [[Bacterial infections]], multiple or recurrent
*[[Coccidioidomycosis]], disseminated or extrapulmonary
* [[Lymphoid interstitial pneumonia]] or pulmonary lymphoid hyperplasia complex
*[[Cryptococcosis]], extrapulmonary
*[[Cryptosporidiosis]], chronic intestinal for longer than 1 month
*[[Cytomegalovirus]] disease (other than [[liver]], [[spleen]] or [[lymph nodes]]
*[[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]], immunoblastic or primary brain
*Mycobacterium avium complex
*Mycobacterium, other species, disseminated or extrapulmonary
*[[Pneumocystis jiroveci pneumonia]] (formerly Pneumocystis carinii)
*[[Pneumonia]] (recurrent)
*[[Progressive multifocal leukoencephalopathy]]
*[[Salmonella]] septicemia (recurrent)
*[[Toxoplasmosis]] of the brain
*[[Tuberculosis]]
*Wasting syndrome due to HIV
 
People who are not infected with [[HIV]] may also develop these conditions; this does not mean they have [[AIDS]]. However, when an individual presents laboratory evidence against HIV infection, a diagnosis of AIDS is ruled out unless the patient has not:
 
undergone high-dose corticoid therapy or other immunosuppressive/cytotoxic therapy in the three months before the onset of the indicator disease '''OR''' 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''' a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia
 
'''AND'''
 
the individual has had ''Pneumocystis jiroveci'' pneumonia '''OR''' one of the above defining illnesses '''AND''' a CD4+ T-cell count below 200 cells/µl (or a CD4+ T-cell percentage of total lymphocytes of less than 14%).
==Historical Perspective==
 
In 1993, the CDC added pulmonary [[tuberculosis]], recurrent [[pneumonia]], and invasive [[cervical cancer]]<ref>CDC. [http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults]</ref> to the list of clinical conditions in the [[AIDS]] surveillance case definition published in 1987<ref name="pmid3039334">{{cite journal |author= |title=Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. Council of State and Territorial Epidemiologists; AIDS Program, Center for Infectious Diseases |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=36 Suppl 1 |issue= |pages=1S–15S |year=1987 |month=August |pmid=3039334 |doi= |url=}}</ref> and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of less than 200 cells/uL or a CD4+ percentage of less than 14.


==References==
==References==
{{reflist|2}}
*CDC. Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 1987;36:1-15S.  
*CDC. Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 1987;36:1-15S.  
*CDC. [http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults]
*CDC. [http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults]
*[http://aidsinfo.nih.gov/other/cbrochure/english/01_en.html AIDS info]
*[http://aidsinfo.nih.gov/other/cbrochure/english/01_en.html AIDS info]
*[http://www.aidsonline.com/pt/re/aids/abstract.00002030-199809000-00006.htm Disease progression and survival following specific AIDS-defining conditions: a retrospective cohort study of 2048 HIV-infected persons in London.]
*[http://www.aidsonline.com/pt/re/aids/abstract.00002030-199809000-00006.htm Disease progression and survival following specific AIDS-defining conditions: a retrospective cohort study of 2048 HIV-infected persons in London.]
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]

Overview

AIDS is defined as an the presence of either of the following in a patient with HIV infection: a CD4+ T-cell count below 200 cells/µl, a CD4+ T-cell percentage of total lymphocytes of less than 15%, any of the 27 specified AIDS-defining illnesses.

Definition

AIDS Case Definition
According to the CDC definition, a patient has AIDS if he or she is infected with HIV and presents with one of the following:
  • A CD4+ T-cell count below 200 cells/µl
OR
  • A CD4+ T-cell percentage of total lymphocytes of less than 15%
OR
If a patient presents with one of the above conditions but with a negative HIV test, he or she will not normally be considered to have AIDS.
However, an AIDS diagnosis may be given if the patient has had Pneumocystis jiroveci pneumonia, and one of the following conditions:
  • Has not undergone high-dose corticoid therapy or other immunosuppressive/ cytotoxic therapy in the three months before the onset of the indicator disease
OR
  • Has been diagnosed with Hodgkin's disease, Non-Hodgkin's lymphoma, lymphocytic leukemia, multiple myeloma, or any cancer of lymphoreticular or histiocytic tissue, orangioimmunoblastic lymphoadenopathy
OR
  • Has been diagnosed with a genetic immunodeficiency syndrome atypical of HIV infection, such as one involving hypogamma globulinemia.

AIDS-Defining Illnesses

In 1993, the CDC added pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer to the list of clinical conditions in the AIDS surveillance case definition published in 1987 and expanded the AIDS surveillance case definition to include all HIV-infected persons with CD4+ T-lymphocyte counts of less than 200 cells/uL or a CD4+ percentage of less than 14. Considerable variation exists in the relative risk of death following different AIDS defining clinical conditions.

List of AIDS-defining Illnesses

  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 jiroveci 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
  25. Cervical cancer (invasive)
  26. Mycobacterium tuberculosis, any site (pulmonary)
  27. Pneumonia (recurrent)

Children < 13 years

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

References

  1. ↑ Schneider E, Whitmore S, Glynn KM, Dominguez K, Mitsch A, McKenna MT (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. Unknown parameter |month= ignored (help)
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