AIDS/HIV infection


PGL, Persistent generalized lymphadenopathy.


Data from US Centers for Disease Control and Prevention. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992;41(RR-17):1-19.



 



World Health Organization Clinical Staging of HIV/AIDS




Primary HIV infection

Asymptomatic

Acute retroviral syndrome


Clinical stage 1



Asymptomatic

Persistent generalized lymphadenopathy


Clinical stage 2



Moderate unexplained weight loss (<10% body weight)

Recurrent respiratory infections (sinusitis, tonsillitis, otitis media, pharyngitis)

Herpes zoster

Angular cheilitis

Recurrent oral ulceration

Papular pruritic eruptions

Seborrheic dermatitis

Fungal nail infections


Clinical stage 3



Severe, unexplained weight loss (>10% body weight)

Unexplained diarrhea lasting >1 month

Unexplained, persistent, constant or intermittent fever >1 month (>37.6° C)

Persistent oral candidiasis

Oral hairy leukoplakia

Pulmonary tuberculosis

Severe presumed bacterial infections (pneumonia, empyema, pyomyositis, bone and joint infections, meningitis, bacteremia)

Acute necrotizing gingivitis, stomatitis, periodontitis

Unexplained anemia (hemoglobin <8 g/dL)

Neutropenia (<500 cells/mm3)

Chronic thrombocytopenia (<50,000 cells/mm3)


Clinical stage 4



All of the AIDS indicator conditions as defined by the CDC classification and

Atypical disseminated leishmaniasis

Symptomatic HIV-associated nephropathy

Symptomatic HIV-associated cardiomyopathy

Reactivation of American trypanosomiasis (meningoencephalitis or myocarditis)

CDC, Centers for Disease Control and Prevention.


Modified from World Health Organization. Case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV related disease in adults and children. Geneva, WHO, 2007. www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf.




Category B: Symptomatic conditions

These conditions must indicate defective cell-mediated immunity caused by HIV infection, or their clinical course and management must be complicated by HIV. Category B conditions include the following:



• Constitutional symptoms (fever >38.5° C or diarrhea) lasting more than 1 month

• Candidiasis: oropharyngeal or persistent or recurrent vulvovaginal

• Pelvic inflammatory disease

• Moderate or severe cervical dysplasia or carcinoma in situ

• Oral hairy leukoplakia

• Idiopathic thrombocytopenic purpura

• Peripheral neuropathy

• More than two episodes of multidermatomal herpes zoster

• Bacillary angiomatosis


Category C: AIDS-defining illnesses

Including bacterial, viral, fungal infections, parasitic infestations, and some cancers



Bacterial:



• Mycobacterium tuberculosis infection at any site, pulmonary or extrapulmonary

• Mycobacterium avium complex disease; infection with Mycobacterium kansasii or other species, disseminated or extrapulmonary

• Mycobacterium, any species disseminated or extrapulmonary

• Bacterial pneumonia, recurrent (>2 episodes in 12 months)

• Nontyphoid Salmonella septicemia, recurrent


Viral:



• Cytomegalovirus disease (other than liver, spleen, or nodes) and retinitis with vision loss

• Herpes simplex virus (chronic ulcer persisting >1 month, bronchitis, pneumonitis, esophagitis)

• Progressive multifocal leukoencephalopathy


Fungal:



• Candidiasis of the esophagus, bronchi, trachea, or lungs

• Coccidioidomycosis, disseminated or extrapulmonary

• Cryptococcosis, extrapulmonary

• Histoplasmosis, disseminated or extrapulmonary

• Isosporiasis, chronic intestinal (persisting for >1 month)

• Pneumonia, recurrent (Pneumocystis jiroveci)

Dec 2, 2016 | Posted by in ANESTHESIA | Comments Off on AIDS/HIV infection
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