Clinical and epidemiological implications of the Centers for Disease Control/World Health Organization reclassification of AIDS cases

Abstract

We therefore suggest that the stricter, biologically more plausible, case definition used in Scotland of two consecutive CD4 cell counts of < or = 200 x 10(6)/l [CD4(200) (x 2)] should be adopted--not as a new definition of AIDS, but as an additional important state of severe HIV-related immunodeficiency (SHRID). Median survival under the CD4(200) (x 2) case definition was 40 months in the Edinburgh cohort. We have illustrated differences in CD4(200) case ascertainment between injecting drug users and other HIV-infected patients in the Edinburgh City Hospital Cohort. We recommend that surveillance centres should ascertain date of first immunological monitoring as well as date of SHRID diagnosis in order to identify differential case ascertainment.