CLASSIFICATION OF CLINICAL SPECTRUM FOR HIV INFECTION

The 1993 Revised CDC Classification System

World Health Organization Classification System for HIV Infection

Picture / Photo of HIV infection / condition

 

 

The 1993 Revised CDC Classification System

CD4+ T cell categories
(cells/cu mm)		 Clinical categories*
  A B C
  Asymptomatic,acute (primary)
HIV or PGL**		 Symptomatic,
not A or C Conditions#		 AIDS Indicator Conditions##
(1)  >=500 A1 B1 C1
(2) 200-499 A2 B2 C2
(3) <200 A3 B3 C3
* Persons in categories A3, B3, C1, C2, and C3 have AIDS under the 1993 surveillance case definition (given below).
** PGL = persistent generalized lymphadenopathy. Clinical Category A includes acute (primary) HIV infection.
# See clinical categories below.
## See list of AIDS-defining conditions for 1993 definition below

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Category A

Category A consists of one or more of the conditions listed below in an adolescent or adult (> 13 years) with documented HIV infection. Conditions listed in Categories B and C must not have occurred.

Category B

Category B consists of symptomatic conditions in an HIV-infected adolescent or adult that are not included among conditions listed in clinical Category C and that meet at least one of the following criteria: (a) the conditions are attributed to HIV infection or are indicative of a defect in cell-mediated immunity; or (b) the conditions are considered by physicians to have a clinical course or to require management that is complicated by HIV infection. Examples of conditions in clinical category B include but are not limited to:

For classification purposes, Category B conditions take precedence over those in Category A. For example, someone previously treated for oral or persistent vaginal candidiasis (and who has not developed a Category C disease) but who is now asymptomatic should be classified in Category B [top]

Category C

Category C includes the clinical conditions listed in the 1993 AIDS surveillance case definition. For classification purposes, once a Category C condition has occurred, the person will remain in Category C [top]

 

The 1993 CDC Adult and Pediatric AIDS Case Definitions for Surveillance [top]

Adult AIDS

Adult AIDS is defined as either AIDS Defining Conditions

Pediatric AIDS

Pediatric AIDS is defined as a case of AIDS in a person less than 13 years old, and differs from the adult definition in two ways:

1. The additional diagnoses of multiple or serious bacterial infections and lymphoid interstitial pneumonia/pulmonary lymphoid hyperplasia are AIDS-defining conditions in a person < 13 years old but not in an adult.

2. For a child less than 15 months old, an HIV antibody test is insufficient evidence of HIV infection because of the persistence of passively acquired maternal antibodies in the first 15 months after birth. A positive HIV serum antigen test, viral culture, or nucleic acid probe is evidence of HIV infection. A serum sample repeatedly reactive for HIV antibody is accepted as evidence of infection only if the mother is thought to be not infected with HIV perinatally, or if the positive serology is accompanied by both increased serum immunoglobulin and an abnormality of the absolute lymphocyte count, the CD4 lymphocyte count, or the CD4 to CD8 ratio.

To confirm a diagnosis of pediatric AIDS, it is also necessary to rule out congenital infections with Toxoplasma gondii or herpes simplex in an infant less than 1 month old and cytomegalovirus in an infant less than 6 months old, and to rule out other primary and secondary immune deficiencies seen in children. [top]

 

World Health Organization Classification System for HIV Infection

Clinical Stage 1 Clinical Stage 2 Clinical Stage 3 Clinical Stage 4

 

Picture / Photo of HIV infection / condition [top]

CANDIDIASIS

COCCIDIOIDOMYCOSIS

 CRYPTOcoccus

HISTOplasmosis

  
         
         
         

 

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