A positive result on a screening test for HIV antibody (e.g., repeatedly reactive enzyme immunoassay), followed by a positive result on a confirmatory test for HIV antibody (e.g., Western blot or immunofluorescence antibody test)
A positive result or report of a detectable quantity on any of the following HIV virologic (nonantibody) tests: HIV nucleic acid (DNA or RNA) detection (e.g., DNA polymerase chain reaction [PCR] or plasma HIV RNA); HIV p24 antigen test, including neutralization assay; and HIV isolation (viral culture)
CD4+ T lymphocyte count less than 200 cells/mm3 (or CD4+ T lymphocyte percentage <14%) and laboratory evidence of HIV infection
Presence of an AIDS-indicator disease (candidiasis of the esophagus, trachea, bronchi, or lungs; invasive cervical cancer; extrapulmonary Coccidioidomycosis; extrapulmonary cryptococcosis; cryptosporidiosis with diarrhea for more than 1 month; cytomegalovirus (CMV) infection of any organ other than the liver, spleen, or lymph nodes; herpes simplex infection with mucocutaneous ulcer for more than 1 month or bronchitis, pneumonitis, or esophagitis; extrapulmonary histoplasmosis; HIV-associated dementia; HIV-associated wasting; isosporiasis with diarrhea for more than 1 month; Kaposi sarcoma in a patient younger than 60 years of age; disseminated Mycobacterium avium; pulmonary or extrapulmonary tuberculosis (TB); Pneumocystis jiroveci pneumonia; recurrent bacterial pneumonia; progressive multifocal leukoencephalopathy; recurrent Salmonella septicemia (nontyphoid); and toxoplasmosis) and laboratory evidence of HIV infection
MSM and their sexual contacts
Intravenous drug users and their sexual contacts
Persons who received blood and blood products prior to 1985
Children born to infected women
for bacterial pneumonia, with positive sputum cultures and infiltrates on chest radiograph. Such pneumonias are 20 times more common in HIV patients with low CD4 cell counts (<200 cells/mm3) than in those with normal counts. The recurrent development of such pneumonias represents significant immunosuppression.
addressed in the 1993 CDC surveillance definition of AIDS (see prior discussion), which expanded the list of indicator conditions to include pulmonary TB, invasive cervical cancer, and recurrent pneumonia in patients who are HIV seropositive. In addition, the importance of immune status is acknowledged in these diagnostic criteria, with HIV-seropositive patients having a CD4 cell count less than 200 (<15% of lymphocytes) included among those considered to have AIDS.
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