HIV pediatric classification system: Difference between revisions
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|[[Cryptosporidiosis]] or [[isosporiasis]] with [[diarrhea]] persisting >1 month | |[[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): a) failure to attain or loss of developmental milestones or loss of intellectual ability, verified by standard developmental scale or neuropsychological tests; 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); c) acquired symmetric motor deficit manifested by two or more of the following:paresis, pathologic reflexes, ataxia, or gait disturbance | |[[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): '''a)''' failure to attain or loss of developmental milestones or loss of intellectual ability, verified by standard developmental scale or neuropsychological tests;''' 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); '''c)''' acquired symmetric motor deficit manifested by two or more of the following:paresis, pathologic reflexes, ataxia, or gait disturbance | ||
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Revision as of 23:36, 10 June 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Ujjwal Rastogi, M.B.B.S. [2]
Overview
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.
Pediatric Classification System
| Category N: Not Symptomatic |
| 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. |
| Category A: Mildly Symptomatic |
| Children with two or more of the following conditions but none of the conditions listed in Categories B and C: |
| Lymphadenopathy (≥0.5 cm at more than two sites; bilateral = one site) |
| Hepatomegaly |
| Splenomegaly |
| Dermatitis |
| Parotitis |
| Recurrent or persistent upper respiratory infection, sinusitis, or otitis media |
| Category B: Moderately Symptomatic |
| 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: |
| Anemia (<8 gm/dL), neutropenia (<1,000 cells/mm3), or thrombocytopenia (<100,000 cells/mm3) persisting ≥30 days. |
| Bacterial meningitis, pneumonia, or sepsis (single episode) |
| Candidiasis, oropharyngeal (i.e., thrush) persisting for >2 months in children age >6 months |
| Cardiomyopathy |
| Cytomegalovirus infection with onset before age 1 month |
| Diarrhea, recurrent or chronic |
| Hepatitis |
| Herpes simplex virus (HSV) stomatitis, recurrent (i.e., more than two episodes within 1 year) |
| HSV bronchitis, pneumonitis, or esophagitis with onset before age 1 month |
| Herpes zoster (i.e., shingles) involving at least two distinct episodes or more than one dermatome |
| Leiomyosarcoma |
| Lymphoid interstitial pneumonia (LIP) or pulmonary lymphoid hyperplasia complex |
| Nocardiosis |
| Fever lasting >1 month |
| Toxoplasmosis with onset before age 1 month |
| Varicella, disseminated (i.e., complicated chickenpox) |
| Category C: Severely Symptomatic |
| 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): |
| 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) |
| Candidiasis, esophageal or pulmonary (bronchi, trachea, lungs) |
| Coccidioidomycosis, disseminated (at site other than or in addition to lungs or cervical or hilar lymph nodes) |
| Cryptococcosis, extrapulmonary |
| Cryptosporidiosis or isosporiasis with diarrhea persisting >1 month |
| 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): a) failure to attain or loss of developmental milestones or loss of intellectual ability, verified by standard developmental scale or neuropsychological tests; 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); c) acquired symmetric motor deficit manifested by two or more of the following:paresis, pathologic reflexes, ataxia, or gait disturbance |