AIDS (HIV): Classification

HIV/AIDS classification: CDC classification (CDC, Centers for Disease Control and Prevention).

Category Clinical stages Symptoms/diseases
A Acute HIV infection
  • Asymptomatic HIV infection
  • Acute, symptomatic (primary) HIV infection/acute HIV syndrome (also in the history): mononucleosis-like clinical picture with short-term lymphadenopathy (swelling of the lymph nodes), fever and splenomegaly (spleen enlargement)
  • Persistent generalized lymphadenopathy (LAS) > 3 months, no general symptoms.
  • Latent phase: clinically healthy but infectious (duration: on average about 10 years, depending on immune status nutritional status and age).
B Symptomatic HIV infection Non-AIDS defining symptoms and illnesses:

  • Constitutional symptoms such as.
    • Fever > 38.5 °C or diarrhea (diarrhea) existing for > 4 weeks.
  • HIV-associated neuropathy (diseases of the peripheral nervous system).
  • Idiopathic thrombocytopenic purpura (IPT).
  • Opportunistic infections:
    • Bacillary angiomatosis
    • Herpes zoster when multiple dermatomes are affected (area of skin autonomously supplied by the sensory fibers of a spinal nerve root/spinal cord root) or after recurrence (recurrence of disease) in one dermatome
    • Listeriosis
    • Oral hairy leukoplakia
    • Oropharyngeal Candida infection (in the mouth and throat area).
    • Pelvic inflammatory disease, especially with complications of tubal or ovarian abscess.
    • Vulvovaginal candida infections that are either chronic (> 1 month) or poorly treatable
  • Cervical dysplasia or carcinoma in situ.
C AIDS AIDS-defining diseases:

  • Wasting syndrome: unintentional weight loss of >10% of original body weight over a 6-month period with concomitant chronic diarrhea (diarrhea) without evidence of pathogens and/or fever
  • HIV-associated encephalopathy: HIV dementia.
  • Opportunistic infections
    • Systemic candidiasis (esophageal Candida infection or infestation of bronchi, trachea or lungs).
    • Chronic herpes simplex ulcers or herpes bronchitis, pneumonia, or esophagitis.
    • HSV encephalitis
    • CMV retinitis
    • Generalized CMV infection (not of liver or spleen).
    • Recurrent salmonella septicemia.
    • Recurrent pneumonias within one year
    • Pneumocystitis jiroveci pneumonia
    • Crytococcosis (pulmonary or extrapulmonary).
    • Chronic intestinal cryptosporidial infection.
    • Chronic intestinal infection with Isospora belli
    • Histoplasmosis (extrapulmonary or disseminated).
    • Tuberculosis
    • Infections with Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary.
    • Progressive multifocal leukoencephalopathy.
    • Cerebral toxoplasmosis (Toxoplasma encephalitis).
    • Visceral leishmaniasis (inclusion as an AIDS-associated infection is discussed).
  • Malignancies:
    • Kaposi’s sarcoma
    • Malignant lymphoma (Burkitt’s, immunoblastic, or primary cerebral lymphoma)
    • Invasive cervical carcinoma
    • Hodgkin’s lymphoma and anal carcinoma (inclusion as AIDS-defining due to increased relative incidence is debated).

Depending on the T helper cell count (CD4 lymphocytes), the stages are further subdivided:

CD4 lymphocytes Stages
> 500/µl A1 B1 C1
200-499/µl A2 B2 C2
< 200/µl A3 B3 C3