AIDSdefining conditions

The original US Centers for Disease Control (CDC) classification has been modified with time to provide a more simplified scheme for defining AIDS. The HIV/AIDS case surveillance system simply specifies a list of clinical conditions associated with the late stages of HIV infection as being 'AIDS-defining'. 7

The AIDS-defining conditions are:

• candidiasis of bronchi, trachea or lungs

• candidiasis, oesophageal

• cervical cancer, invasive

• coccidioidomycosis, disseminated or extrapulmonary

• cryptococcosis, extrapulmonary

• cryptosporidiosis, chronic intestinal (> 1 month's duration)

• cytomegalovirus disease (other than liver, spleen, or nodes)

• cytomegalovirus retinitis (with loss of vision)

• encephalopathy, HIV-related

• herpes simplex: chronic ulcer(s) (> 1 month's duration); or bronchitis, pneumonitis or oesophagitis

• histoplasmosis, disseminated or extrapulmonary

• isosporiasis, chronic intestinal (> 1 month's duration)

• Kaposi's sarcoma

• lymphoma, Burkitt's (or equivalent term)

• lymphoma, immunoblastic (or equivalent term)

• lymphoma, primary, of brain

• Mycobacterium avium complex of M. Kansasii, disseminated or extrapulmonary

• Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)

• Mycobacterium, other species or unidentified species, disseminated or extrapulmonary

• Pneumocystis carinii pneumonia

• Salmonella septicaemia, recurrent

• toxoplasmosis of brain

• wasting syndrome due to HIV

General fever iti g hit sweats lethargy/ma laise anorexia pharyngiLls arthralgia myalgia lympnadenopathy

Derma topathic maculopapular rash roseoia-like rash alopecia urticaria (diffuse) desquamation herpes simpiex reactivation herpes zoster

Gastrointestinal nral candidiasis naysfifVvornitirirf diarrhoea rTinoocutaneous ulceration

Fig. 24.1 Possible clinical features of primary HIV infection

Neuropathic cognitive/affective Impairment headache photophobia meningoen cepria I itis radiculopathy

Brachial neuriLis peripheral neuropathy

Guillain-Uarire syndrome

Gastrointestinal nral candidiasis naysfifVvornitirirf diarrhoea rTinoocutaneous ulceration

Laboratory tests

WCC 1 Platelets J ESR t (slight) s, transaminases r HIV -ve Recovery phase: lymphocytosis atypical mononuclears Inversion CDj : CDg ratio 3—12 weeks later HIV +ve

Fig. 24.1 Possible clinical features of primary HIV infection

The Australian AIDS surveillance case definition does not refer to the CD4 cell count although in the United States AIDS is also defined by CD4 cell count of < 200/^L, regardless of clinical condition.

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