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| __NOTOC__
| | #REDIRECT[[AIDS classification#WHO staging system for HIV infection and disease in children]] |
| {{AIDS}}
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| {{CMG}} {{AOEIC}} {{UJ}}
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| ==Overview==
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| Additional knowledge of the progression of HIV disease among children lead to the development of revised classification system for HIV infection in children in 1994 which replaced the [[pediatric]] HIV classification system that was published earlier in 1987.
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| ==Pediatric Classification System==
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| {| class=wikitable border=1
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| |style="height:100px"; border="1" bgcolor="DarkGray" align="center"|Category N: Not Symptomatic
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| |-
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| |Children who have no signs or symptoms considered to be the result of HIV infection or who have only one of the conditions listed in category A.
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| |-
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| |style="height:100px"; border="1" bgcolor="DarkGray" align="center"|Category A: Mildly Symptomatic
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| |Children with two or more of the following conditions but none of the conditions listed in Categories B and C:
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| |[[Lymphadenopathy]] (≥0.5 cm at more than two sites; bilateral = one site)
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| |-
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| |[[Hepatomegaly]]
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| |[[Splenomegaly]]
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| |[[Dermatitis]]
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| |-
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| |[[Parotitis]]
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| |Recurrent or persistent [[Upper respiratory tract infection|upper respiratory infection]], [[sinusitis]], or [[otitis media]]
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| |-
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| |style="height:100px"; border="1" bgcolor="DarkGray" align="center"|Category B: Moderately Symptomatic
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| |Children who have symptomatic conditions, other than those listed for Category A or Category C, that are attributed to HIV infection. Examples of conditions in Clinical Category B include, but are not limited to, the following:
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| |[[Anemia]] (<8 gm/dL), [[neutropenia]] (<1,000 cells/mm3), or [[thrombocytopenia]] (<100,000 cells/mm3) persisting ≥30 days.
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| |-
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| |[[Bacterial meningitis]], [[pneumonia]], or [[sepsis]] (single episode)
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| |[[Candidiasis]], [[oropharyngeal]] (i.e., thrush) persisting for >2 months in children age >6 months
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| |[[Cardiomyopathy]]
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| |[[Cytomegalovirus]] infection with onset before age 1 month
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| |[[Diarrhea]], recurrent or chronic
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| |[[Hepatitis]]
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| |[[Herpes simplex virus]] (HSV) [[stomatitis]], recurrent (i.e., more than two episodes within 1 year)
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| |HSV [[bronchitis]], [[pneumonitis]], or [[esophagitis]] with onset before age 1 month
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| |[[Herpes zoster]] (i.e., [[shingles]]) involving at least two distinct episodes or more than one dermatome
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| |[[Leiomyosarcoma]]
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| |[[Lymphoid interstitial pneumonia]] (LIP) or pulmonary lymphoid hyperplasia complex
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| |[[Nocardiosis]]
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| |[[Fever]] lasting >1 month
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| |[[Toxoplasmosis]] with onset before age 1 month
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| |[[Varicella]], disseminated (i.e., complicated [[chickenpox]])
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| |style="height:100px"; border="1" bgcolor="DarkGray" align="center"|Category C: Severely Symptomatic
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| |Children who have any condition listed in the 1987 surveillance case definition for acquired immunodeficiency syndrome (below), with the exception of LIP (which is a Category B condition):
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| |Serious bacterial infections, multiple or recurrent (i.e., any combination of at least two culture-confirmed infections within a 2-year period), of the following types: [[septicemia]], [[pneumonia]], [[meningitis]], [[bone]] or joint infection, or [[abscess]] of an internal organ or body cavity (excluding [[otitis media]], superficial skin or mucosal abscesses, and indwelling catheter-related infections)
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| |-
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| |[[Candidiasis]], esophageal or pulmonary (bronchi, trachea, lungs)
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| |[[Coccidioidomycosis]], disseminated (at site other than or in addition to lungs or cervical or hilar lymph nodes)
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| |[[Cryptococcosis]], extrapulmonary
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| |[[Cryptosporidiosis]] or [[isosporiasis]] with [[diarrhea]] persisting >1 month
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| |[[Encephalopathy]] (at least one of the following progressive findings present for at least 2 months in the absence of a concurrent illness other than HIV infection that could explain the findings)
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| : '''a)''' failure to attain or loss of developmental milestones or loss of intellectual ability, verified by standard developmental scale or neuropsychological tests;
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| :''' b)''' impaired brain growth or acquired microcephaly demonstrated by head circumference measurements or brain atrophy demonstrated by computerized tomography or magnetic resonance imaging (serial imaging is required for children <2 years of age);
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| :'''c)''' acquired symmetric motor deficit manifested by two or more of the following:paresis, pathologic reflexes, ataxia, or gait disturbance
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| |-
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| |[[Herpes simplex virus]] infection causing a mucocutaneous ulcer that persists for >1 month or [[bronchitis]], [[pneumonitis]], or esophagitis for any duration affecting a child >1 month of age
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| |[[Histoplasmosis]], disseminated (at a site other than or in addition to lungs or cervical or hilar lymph nodes)
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| |[[Kaposi's sarcoma]]
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| | Lymphoma, primary, in brain
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| |Lymphoma, small, noncleaved cell (Burkitt's), or immunoblastic or large cell lymphoma of B-cell or unknown immunologic phenotype
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| |[[Mycobacterium tuberculosis]], disseminated or extrapulmonary
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| |Mycobacterium, other species or unidentified species, disseminated (at a site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
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| |[[Mycobacterium avium complex]] or Mycobacterium kansasii, disseminated (at site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)
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| |[[Pneumocystis jiroveci pneumonia]]
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| |[[Progressive multifocal leukoencephalopathy]]
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| |[[Salmonella]] (nontyphoid) [[septicemia]], recurrent
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| |Toxoplasmosis of the brain with onset at >1 month of age
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| |[[Wasting syndrome]] in the absence of a concurrent illness other than HIV infection that could explain the following findings:
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| : a) persistent weight loss >10% of baseline; OR
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| :b) downward crossing of at least two of the following percentile lines on the weight-for-age chart (e.g., 95th, 75th, 50th, 25th, 5th) in a child ≥1 year of age; OR
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| :c) <5th percentile on weight-for-height chart on two consecutive measurements, ≥30 days apart PLUS 1) chronic diarrhea (i.e., ≥ two loose stools per day for >30 days), OR 2) documented fever (for ≥30 days, intermittent or constant)
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| |}
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| ==References==
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| {{reflist|2}}
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| {{WH}}
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| {{WS}}
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| [[Category:HIV/AIDS]]
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| [[Category:Classification systems]]
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| [[Category:Disease]]
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| [[Category:Immune system disorders]]
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| [[Category:Infectious disease]]
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| [[category:viral diseases]]
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| [[Category:Pandemics]]
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| [[Category:Sexually transmitted infections]]
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| [[Category:Syndromes]]
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| [[Category:Virology]]
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| [[Category:AIDS origin hypotheses]]
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| [[Category:Medical disasters]]
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| [[Category:Acronyms]]
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| [[Category:Immunodeficiency]]
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| [[Category:Microbiology]]
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