CDC AIDS definition

• If no laboratory evidence of HIV:
  • If there are no other cause of immunodeficiency (listed in I.A below) and an indicator disease from I.B definitively diagnosed, then AIDS.
• If laboratory evidence of HIV:
  • If an indicator disease from I.B or II.A is definitively diagnosed or a disease from II.B is presumptively diagnosed, then AIDS.
• If laboratory evidence of HIV is negative:
  • If there is no other cause of immunodeficiency from I.A and P. carinii is definitively diagnosed then AIDS.
  • If there is no other cause of immunodeficiency from I.A and CD4<400 and an indicator disease from I.B is definitively diagnosed, then AIDS.

The 1993 definition (MMWR 41(RR-17)) expands the definition. It adds all HIV-infected persons with CD4<200 or CD4%<14. It adds all HIV-infected persons with pulmonary tuberculosis, recurrent pneumonia, or invasive cervical cancer.

I.A Causes of immunodeficiency that disqualify diseases as indicators of AIDS in the absence of laboratory evidence for HIV infection

• high-dose or long-term systematic corticosteroid therapy or other immunosuppressive/cytotoxic therapy <= 3 months before the onset of the indicator disease.
• any of the following diseases diagnosed <= 3 months after diagnosis of the indicator disease: Hodgkin's disease, nono-Hodgkin's lymphoma (other than primary brain lymphoma), lymphocytic leukemia, multiple myeloma, any other cancer of lymphoreticular or histiocytic tissue, or angioimmunoblastic lymphadenopathy.
• a genetic (congenital) immunodeficiency syndrome or an acquired immunodeficiency syndrome atypical of HIV infection, such as one involving hypogammaglobulinemia

I.B Indicator diseases diagnosed definitively

• candidiasis of the esophagus, trachea, bronchi, or lungs
• cryptococcosis, extrapulmonary
• cryptosporidosis with diarrhea persisting >1 month
• cytomegalovirus disease of an organ other than liver, spleen, or lymph nodes in a patient >1 month of age
• herpes simplex virus infection causing a mucocutaneous ulcer that persists longer than 1 month; or bronchitis, pneumonitis, or esophagitis for any duration affecting a patient >1 month of age
• Kaposi's sarcoma affecting a patient < 60 years of age
• lymphoma of the brain (primary) affecting a patient < 60 years of age
• lymphoid interstitial pneumonia and/or pulmonary lymphoid hyperplasia (LIP/PLH complex) affecting a child <13 years of age
• Mycobacterium avium complex or M. kansasii disease, disseminated (at a site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
• Pneumocystis carinii pneumonia
• progressive multifocal leukoencephalopathy
• toxoplasmosis of the brain affecting a patient >1 month of age

II.A Indicator diseases diagnosed definitively

• bacterial infections, multiple or recurrent (any combination of at least two within a 2-year period), of the following types affecting a child <13 years of age: septicemia, pneumonia, meningitis, bone or joint infection, or abscess of an internal organ or body cavity (excluding otitis media or superficial skin or mucosal abscesses), caused by Haemophilus, Streptococcus (including pneumococcus), or other pyogenic bacteria
• coccidioidomycosis, disseminated (at a site other than or in addition to lungs or cervical or hilar lymph nodes)
• HIV encephalopathy (also called "HIV dementia", "AIDS dementia," or "subacute encephalitis due to HIV")
• histoplasmosis, disseminated (at a site other than or in addition to lungs or cervical or hilar lymph nodes)
• isosporiasis with diarrhea persisting >1 month
• Kaposi's sarcoma at any age
• lymphoma of the brain (primary) at any age
• other non-Hodgkin's lymphoma of B-cell or unknown immunologic phenotype and the following histologic types:
  • small noncleaved lymphoma (either Burkitt or non-Burkitt type)
  • immunoblastic sarcoma (equivalent to any of the following, although not necessarily all in combination: immunoblastic lymphoma, large-cell lymphoma, diffuse histiocytic lymphoma, diffuse undifferentiated lymphoma, or high-grade lymphoma)
• any mycobacterial disease caused by mycobacteria other than M. tuberculosis, disseminated (at a site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
• disease caused by M. tuberculosis, extrapulmonary (involving at least one site outside the lungs, regardless of whether there is concurrent pulmonary involvement)
• Salmonella (nontyphoid) septicemia, recurrent
• HIV wasting syndrome (emaciation, "slim disease")

II.B Indicator diseases diagnosed presumtively

• candidiasis of the esophagus
• cytomegalovirus retinitis with loss of vision
• Kaposi's sarcoma
• lymphoid interstitial pneumonia and/or pulmonary lymphoid hyperplasia (LIP/PLH complex) affecting a child <13 years of age
• mycobacterial disease (acid-fast bacilli with species not identified by culture), disseminated (involving at least one site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
• Pneumocystis carinii pneumonia
• toxoplasmosis of the brain affecting a patient >1 month of age

Glossary