Page 71 - AIDSBK23C

Page 71

DIAGNOSTIC CRITERIA FOR AIDS IN CHILDREN, ADOLESCENTS AND ADULTS

The Centers for Disease Control (CDC) have promulgated criteria for diagnosis,
reporting, and clinical staging of AIDS in the United States based upon knowledge about HIV,
available laboratory testing, and clinical course.[389,390,391,392,393]

The 2008 CDC revised surveillance case definition for HIV infection applies to any HIV
(including HIV-1 and HIV-2) infection and incorporates the reporting criteria for HIV infection
and AIDS into a single case definition and excludes confirmation of HIV infection through
diagnosis of AIDS-defining conditions alone. The criteria are as follows:[394]

2008 Surveillance Case Definition for HIV Infection Among Adults and Adolescents

For surveillance purposes, a reportable case of HIV infection among adults and adolescents aged
>13 years is categorized by increasing severity as stage 1, stage 2, or stage 3 (AIDS) or as stage
unknown.

Laboratory Criteria

Positive result from an HIV antibody screening test (e.g., reactive enzyme immunoassay
[EIA]) confirmed by a positive result from a supplemental HIV antibody test (e.g.,
Western blot or indirect immunofluorescence assay test).

OR

Positive result or report of a detectable quantity (i.e., within the established limits of the
laboratory test) from any of the following HIV virologic (i.e., non-antibody) tests: &-- HIV
nucleic acid (DNA or RNA) detection test (e.g., polymerase chain reaction [PCR]) &-- HIV
p24 antigen test, including neutralization assay &-- HIV isolation (viral culture).

Other Criterion (for Cases that Do Not Meet Laboratory Criteria)

HIV infection diagnosed by a physician or qualified medical-care provider based on the
laboratory criteria and documented in a medical record. Oral reports of prior laboratory
test results are not acceptable.

Case Classification

A confirmed case meets the laboratory criteria for diagnosis of HIV infection and one of
the four HIV infection stages (stage 1, stage 2, stage 3, or stage unknown). Although
cases with no information on CD4+ T-lymphocyte count or percentage and no
information on AIDS-defining conditions can be classified as stage unknown, every
effort should be made to report CD4+ T-lymphocyte counts or percentages and the
presence of AIDS-defining conditions at the time of diagnosis. Additional CD4+ T-
lymphocyte counts or percentages and any identified AIDS-defining conditions can be
reported as recommended.