Monday, August 21, 2017

Medicollabowesome: HIV Infections - Clinical categories

The current CDC classification system for HIV-infected adolescents and adults categorizes persons on the basis of clinical conditions associated with HIV-infection and CD4+ T lymphocytes counts which is represented by a matrix of nine mutually exclusive categories.

Classification system for HIV-infection:
Category A- Asymptomatic, acute HIV or progressive generalized lymphadenopathy
A1 - >500/muL
A2 - 200-499/muL
A3 - <200/muL

Category B- Symptomatic
B1 - >500/muL
B2 - 200-499/muL
B3 - <200/muL

Category C- AIDS indicator conditions
C1 ->500/muL
C2 -200-499/muL
C3 -<200/muL

Clinical manifestations belonging to each category:
Category A- One or more conditions with documented HIV infection and category B and C conditions must not have occured
  • Asymptomatic HIV infection
  • Progressive generalized lymphadenopathy
Category B- Symptomatic conditions that are not included under category C and meets the following criteria, (a) infection is indicative of defect in cell mediated immunity; (b) clinical course and management is complicated by HIV infection.
  • Bacillary angiomatosis
  • Candidiasis- thrush, vulvovaginal
  • Cervical dysplasia/ cervical carcinoma in situ
  • Fever or diarrhea lasting >1 month
  • Hairy leukoplakia
  • Shingles, atleast two distinct episodes or more than one dermatome
  • ITP
  • PID
  • Peripheral neuropathy
  • Listeriosis

Category C- Conditions listed in AIDS surveillance case definition 
  • Candidiasis of bronchi, trachea, lungs, oesophagus
  • Cervical carcinoma invasive
  • Coccidiodomycosis, disseminated or extrapulmonary
  • Cryptococcosis, extrapulomary
  • Cryptosporidiosis, >1 month's duration
  • CMV, other than liver, spleen, nodes
  • CMV retinitis with loss of vision
  • Encephalopathy
  • HSV, ulcers lasting >1 month's duration
  • Histoplasmosis, disseminated or extrapulmonary
  • Isosporiasis, chronic intestinal >1 month
  • Kaposi sarcoma
  • Burkitt's lymphoma
  • Lymphoma of brain
  • MAC
  • MTB
  • Pneumocystis jiroveci pneumonia
  • Recurrent pneumonia
  • Progressive multifocal leucoencephalopathy
  • Salmonella septicemia, recurrent
  • Toxoplasmosis of brain
  • Wasting syndrome due to HIV
Shivani Mangalgi
Medicowesome 2017

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