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Section 3. Summaries of Infectious Diseases

Human Immunodeficiency Virus Infection 128

Clinical Manifestations
Etiology
Epidemiology
Incubation Period
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Human immunodeficiency virus (HIV) infection results in a wide array of clinical manifestations and varied natural history. HIV type 1 (HIV-1) is much more common in the United States than is HIV type 2 (HIV-2). This chapter, therefore, addresses HIV-1 infection, unless otherwise specified. Acquired immunodeficiency syndrome (AIDS) is the name given to the most advanced stage of HIV-1 infection. The Centers for Disease Control and Prevention (CDC) has devised a case definition that comprises AIDS-defining conditions that are used for surveillance (Table 3.24). The CDC classifies all infected children younger than 13 years of age by varying degrees of clinical expression of disease (Table 3.25, p 382) and immunologic status (Table 3.26, p 384). 129, 130 This pediatric classification system emphasizes the importance of the CD4+ T-lymphocyte count and percentage as critical immunologic parameters and as markers of prognosis. Data regarding plasma HIV-1 RNA concentration (viral load) are not included in this classification.


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  		Table 3.24. 1993 Revised Case Definition of AIDS-Defining Conditions for Adults and Adolescents 13 Years of Age and Oldera

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  		Table 3.25. Clinical Categories for Children Younger Than 13 Years of Age With Human Immunodeficiency Virus (HIV) Infectiona

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  		Table 3.26. Pediatric Human Immunodeficiency Virus (HIV) Classification for Children Younger Than 13 Years of Agea

Early manifestations of pediatric HIV infection include unexplained fevers, generalized lymphadenopathy, hepatomegaly, splenomegaly, failure to thrive, persistent or recurrent oral and diaper candidiasis, recurrent diarrhea, . . . [Go to Full Text]