CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN #16 - October 29, 1992
Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) has developed an addition to the proposed expansion of the AIDS surveillance case definition. The new proposed definition is expected to result in more comprehensive monitoring of the epidemic of HIV infection and related disease in the United States.

In the expansion proposed in November 1991, CDC recommended that the definition include all HIV-infected adolescents and adults who have less than 200 CD4+ T-lymphocytes/ L, as well as those persons having any of the clinical conditions listed in the currently used surveillance case definition, which was announced in 1987. The new addition adds pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer in HIV-infected individuals to the proposed expansion of the AIDS surveillance case definition. The CDC document describing the proposed additions to the case definition also discusses ongoing efforts to ensure the confidentiality of AIDS surveillance information.

CDC has proposed the inclusion of these conditions based on current knowledge, including information presented during the open meeting on the AIDS surveillance case definition held in Atlanta on September 2, 1992. CDC believes that this proposal incorporates the thoughtful input provided by a wide variety of health professionals and other interested persons during the past year. Although pulmonary tuberculosis, recurrent pneumonia, and cervical cancer are also diagnosed in persons without HIV infection, data indicate that these illnesses may increase in frequency and severity in immunosuppressed persons. The addition of these conditions to the AIDS surveillance case definition is dependent upon a diagnosis of HIV infection and does not apply to those persons without HIV infection who have any of these conditions.

CDC anticipates implementation of an expanded AIDS surveillance case definition in January 1993. In 1993, CDC expects that 50,000 cases of AIDS will be reported under the current AIDS surveillance case definition, another 30,000-40,000 will meet the proposed criteria for including persons with <200 CD4+ T-lymphocytes/ L or a CD4+ percent <14, and several thousand other persons will meet the proposed criteria for including HIV-infected persons diagnosed with pulmonary tuberculosis, recurrent pneumonia, or cervical cancer.

Persons interested in obtaining a copy of this addendum may write to the CDC National Prevention Information Network, P.O. Box 6003, Rockville, MD 20849-6003; or telephone (800) 458-5231.

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