Assessment of Laboratory Reporting to Supplement Active AIDS Surveillance--Colorado

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Assessment of Laboratory Reporting to Supplement Active AIDS Surveillance--Colorado

Morbidity and Mortality Weekly Report (10/01/93) Vol. 42, No. 38, P. 749

The surveillance case definition for AIDS was expanded in January to include HIV-infected adolescents and adults with CD4 counts lower than 200, pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer. In preparing for the implementation of these new criteria, the Colorado Department of Health (CDH) assessed the usefulness of lab reports of CD4 test results as a supplement to existing procedures for AIDS surveillance in that state. The CDH conducted tests in two Colorado labs that perform CD4 testing, and compared these tests with CDH records of people with the AIDS virus. The surveillance at these two labs identified a significant number of AIDS cases defined by the new case definition. At one lab, 23 percent of persons with CD4 test results had HIV or AIDS, but had not previously been reported by CDH; the figure was 6.5 percent at the other lab. Of 108 previously unreported cases of infection, 85 percent were identified through record reviews indicating an HIV diagnosis in medical records, but without a lab report of an HIV test. Without CD4 testing, these patients probably would have remained unreported until being hospitalized for an opportunistic infection, or until death. The findings suggest that AIDS case surveillance may be enhanced by lab reports of CD4 testing, with provider follow-up or medical record review. Active case identification is critical in ensuring timely and complete disease reporting.

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