1993 Revised Classification System for HIV Infection and Expanded AIDS Surveillance Case Definition for Adolescents and Adults

CDC has revised the classification system for HIV infection to emphasize the clinical importance of the CD4+ T-lymphocyte count in the categorization of HIV-related clinical conditions.

	Clinical Categories
CD4+ T Cell Categories	A Asymptomatic, Acute (Primary) HIV or PGL	B Symptomatic, Not A or C Conditions	C AIDS-Indicator Conditions
>500/uL	A1	B1	C1
200–499/uL	A2	B2	C2
<200/uL	A3	B3	C3

PGL, progressive generalized lymphadenopathy.

 

Clinical Categories of HIV Infection

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.

• Asymptomatic HIV infection

• Persistent generalized lymphadenopathy

• Acute (primary) HIV infection with accompanying illness or history of acute HIV infection

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: (1) The conditions are attributed to HIV infection or are indicative of a defect in cell-mediated immunity; or (2) the conditions are considered by physicians to have a clinical course or to require management that is complicated by HIV infection. Examples include, but are not limited to, the following:

• Bacillary angiomatosis

• Candidiasis, oropharyngeal (thrush)

• Candidiasis, vulvovaginal; persistent, frequent, or poorly responsive to therapy

• Cervical dysplasia (moderate or severe)/cervical carcinoma in situ

• Constitutional symptoms, such as fever (38.5°C) or diarrhea lasting >1 month

• Hairy leukoplakia, oral

• Herpes zoster (shingles), involving at least two distinct episodes or more than one dermatome

• Idiopathic thrombocytopenic purpura

• Listeriosis

• Pelvic inflammatory disease, particularly if complicated by tuboovarian abscess

• Peripheral neuropathy

Category C: Conditions listed in the AIDS surveillance case definition.

• Candidiasis of bronchi, trachea, or lungs

• Candidiasis, esophageal

• 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, pneumonia, or esophagitis

• Histoplasmosis, disseminated or extrapulmonary

• Isosporiasis, chronic intestinal (>1 month’s duration)

• Kaposi’s sarcoma

• Lymphoma, Burkitt’s (or equivalent term)

• Lymphoma, primary, of brain

• Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary

• Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)

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

• Pneumocystis carinii pneumonia

• Pneumonia, recurrent

• Progressive multifocal leukoencephalopathy

• Salmonella septicemia, recurrent

• Toxoplasmosis of brain

• Wasting syndrome due to HIV

 

References:

1. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1-19. [Medline]

 

Created: Mar 26, 2007