A New Definition for AIDS Surveillance

In January 1993, the Centers for Disease Control and Prevention (CDC) expanded the surveillance definition for the acquired immunodeficiency syndrome (AIDS).For adults and adolescents with human immunodeficiency virus (HIV) infection, four new criteria have been added to the previous definition: a measure of immunosuppression (a CD4+ T-lymphocyte count <200/µL or CD4+ percentage <14) and three clinical conditions (pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer). The expanded surveillance definition more accurately represents persons with severe HIV-related immunosuppression and morbidity and should facilitate reporting by physicians. Counseling of individual patients should continue to focus on their clinical and immunologic status rather than on surveillance criteria.

Effective January 1993, the Centers for Disease Control and Prevention (CDC), in collaboration with state and territorial health departments, expanded the surveillance definition for the acquired immunodeficiency syndrome (AIDS) among adults and adolescents in the United States [1]. For persons with human immunodeficiency virus (HIV) infection, this expansion adds a measure of immunosuppression (a CD4+ T-lymphocyte count < 200 cells/µL or a CD4+ percentage < 14) and three clinical conditions: pulmonary tuberculosis, recurrent (two or more episodes within a 12-month period) pneumonia, and invasive cervical cancer. The expanded definition retains the 23 clinical conditions listed in the previous definition. This expansion will more accurately describe HIV-infected persons with advanced immunosuppression and other associated conditions of continuing or increasing public health significance.

Why was it necessary to expand AIDS surveillance criteria? AIDS surveillance is the principal source of information used to monitor and anticipate trends in the HIV epidemic, to describe the …