Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

HIV Infection & AIDS

For further information, see CMDT Part 31 HIV Infection & AIDS

Key Features

Essentials of Diagnosis

  • Modes of transmission

    • Sexual contact with a person with HIV

    • Parenteral exposure to the blood of a person with HIV by needle sharing, needlestick or, very rarely, transfusion

    • Perinatal exposure

  • In acute HIV infection,

    • Acute retroviral syndrome (not always present):

      • Fever

      • Rash

      • Pharyngitis

      • Swollen lymph nodes

      • Aseptic meningitis

    • Positive HIV viral load, with or without a positive HIV antigen/antibody test (as those tests may initially be negative)

  • In chronic HIV infection/AIDS,

    • Prominent systemic complaints: sweats, diarrhea, weight loss, and wasting

    • Opportunistic infections

      • Due to diminished cellular immunity

      • Often life-threatening

    • Aggressive cancers, particularly non-Hodgkin lymphoma

    • Neurologic manifestations

      • Dementia

      • Aseptic meningitis

      • Neuropathy

General Considerations

  • Definition: Centers for Disease Control and Prevention AIDS case definition (Table 31–1)

  • Etiology: HIV-1, a retrovirus

Table 31–1.CDC AIDS case definition for surveillance of adults and adolescents.
View Table||Download (.pdf)
Table 31–1. CDC AIDS case definition for surveillance of adults and adolescents.
Definitive AIDS Diagnoses (with or without laboratory evidence of HIV infection)
   1. Candidiasis of the esophagus, trachea, bronchi, or lungs.
   2. Cryptococcosis, extrapulmonary.
   3. Cryptosporidiosis with diarrhea persisting > 1 month.
   4. Cytomegalovirus disease of an organ other than liver, spleen, or lymph nodes.
   5. Herpes simplex virus infection causing a mucocutaneous ulcer that persists > 1 month; or bronchitis, pneumonitis, or esophagitis of any duration.
   6. Kaposi sarcoma in a patient < 60 years of age.
   7. Lymphoma of the brain (primary) in a patient < 60 years of age.
   8. Mycobacterium avium complex or Mycobacterium kansasii disease, disseminated (at a site other than or in addition to lungs, skin, or cervical or hilar lymph nodes).
   9. Pneumocystis jirovecii pneumonia.
10. Progressive multifocal leukoencephalopathy.
11. Toxoplasmosis of the brain.
Definitive AIDS Diagnoses (with laboratory evidence of HIV infection)
  1. Coccidioidomycosis, disseminated (at a site other than or in addition to lungs or cervical or hilar lymph nodes).
  2. HIV encephalopathy.
  3. Histoplasmosis, disseminated (at a site other than or in addition to lungs or cervical or hilar lymph nodes).
  4. Isosporiasis with diarrhea persisting > 1 month.
  5. Kaposi sarcoma at any age.
  6. Lymphoma of the brain (primary) at any age.
  7. Other non-Hodgkin lymphoma of B cell or unknown immunologic phenotype.
  8. Any mycobacterial disease caused by mycobacteria other than Mycobacterium tuberculosis, disseminated (at a site other than or in addition to lungs, skin, or cervical or hilar lymph nodes).
  9. Disease caused by extrapulmonary M tuberculosis.
10. Salmonella (nontyphoid) septicemia, recurrent.
11. HIV wasting syndrome.
12. CD4 lymphocyte count < 200 cells/mcL or a CD4 lymphocyte percentage < 14%.
13. Pulmonary tuberculosis.
14. Recurrent pneumonia.
15. Invasive cervical cancer.
Presumptive AIDS Diagnoses (with laboratory evidence of HIV infection)
  1. Candidiasis of esophagus: (a) recent onset of retrosternal pain on swallowing; and (b) oral candidiasis.
  2. Cytomegalovirus retinitis. A characteristic appearance on serial ophthalmoscopic examinations.
  3. Mycobacteriosis. Specimen from stool or normally sterile body fluids or tissue from a ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close