AIDS defining clinical condition

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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)