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Summary of the 2012 Consultation on Revision of the HIV Surveillance Case Definition

This new HIV Surveillance Case Definition is intended, after concultation and input from the Council of State and Territorial Epidemiologists (CSTE), to be published in Morbidity and Mortality Weekly Report (MMWR) and implemented by 2013.


Present HIV Disease Classification and AIDS Definition

CDC classification system for HIV-infected adults and adolescents (1993)

CD4 Cell Categories Clinical Categories
A. Asymptomatic, acute HIV, or PGL
B. Symptomatic conditions, not A or C
C. AIDS indicator conditions
(1) ≥500 cells/μL A1 B1 C1
(2) 200-499 cells/μL A2 B2 C2
(3) below 200 cells/μL A3 B3 C3

PGL=persistent generalized lymphadenopathy

Individuals in categories C1, C2, C3, A3 or B3 have a diagnosis of AIDS.

For more information, see:
1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults PDF

Surveillance case definition for human immunodeficiency virus (HIV) infection among adults and adolescents (aged above 13 years) – United States, 2008

Stage Laboratory evidence* Clinical evidence
Stage 1 Laboratory confirmation of HIV infection and
CD4+ T-lymphocyte count of ≥500 cells/μL or
CD4+ T-lymphocyte percentage of ≥29
None required (but no AIDS-defining condition)
Stage 2 Laboratory confirmation of HIV infection and
CD4+ T-lymphocyte count of 200-499 cells/μL or
CD4+ T-lymphocyte percentage of 14-28
None required (but no AIDS-defining condition)
Stage 3 Laboratory confirmation of HIV infection and
CD4+ T-lymphocyte count of<200 cells/μL or
CD4+ T-lymphocyte percentage of <14†
or documentation of an AIDS-defining condition with laboratory confirmation of HIV infection)†

*The CD4+ T-lymphocyte percentage is the percentage of total lymphocytes. If the CD4+ T-lymphocyte count and percentage do not correspond to the same HIV infection stage, select the more severe stage.

†Documentation of an AIDS-defining condition supersedes a CD4+ T-lymphocyte count of >200 cells/μL and a CD4+ T-lymphocyte percentage of total lymphocytes of equal or more than 14. Definitive diagnostic methods for these conditions are available in Appendix C of the 1993 revised HIV classification system and the expanded AIDS case definition (CDC. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992;41:No. RR-17).

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