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TABLE 1-3: Primary HIV infection: Signs and Symptoms (Department of Health and Human Services [DHHS] Guidelines [Ann Intern Med 2002;137: 381])
Fever – 96% Myalgias – 54% Hepatosplenomegaly – 14%
Adenopathy – 74% Diarrhea – 32% Weight loss – 13%
Pharyngitis – 70% Headache – 32% Thrush – 12%
Rash* – 70% Nausea & vomiting – 27% Neurologic symptoms† – 12%

* Erythematous maculopapular rash on face and trunk, sometimes extremities, including palms & soles. Some have mucocutaneous ulceration involving mouth, esophagus, or genitals.

† Aseptic meningitis, meningoencephalitis, peripheral neuropathy, facial palsy, Guillain- Barré syndrome, brachial neuritis, cognitive impairment, or psychosis.

TABLE 1-4:

AIDS Surveillance Case Definition for Adolescents and Adults: 1993
    Clinical Categories  
  A B C*
CD4 Cell Categories Asymptomatic,
or PGL, or Acute
HIV Infection		 Symptomatic†
(not A or C)		 AIDS Indicator
Condition (1987)
>500/mm3
(≥29%)		 A1 B1 C1
200 to 499/mm3
(14% to 28%)		 A2 B2 C2
<200/mm3
(<14%)		 A3 B3 C3

* All patients in categories A3, B3, and C1-3 are defined as having AIDS based on the presence of an AIDS-indicator condition (Table 1-5) and/or a CD4 cell count <200/mm3.

† Symptomatic conditions not included in Category C that are a) attributed to HIV infection or indicative of a defect in cell-mediated immunity or b) considered to have a clinical course or management that is complicated by HIV infection. Examples of B conditions include, but are not limited to, bacillary angiomatosis; thrush; vulvovaginal candidiasis that is persistent, frequent, or poorly responsive to therapy; cervical dysplasia (moderate or severe); cervical carcinoma in situ; constitutional symptoms such as fever (38.5°C) or diarrhea >1 month; oral hairy leukoplakia; herpes zoster involving two episodes or >1 dermatome; idiopathic thrombocytopenic purpura (ITP); listeriosis; pelvic inflammatory disease (PID), especially if com plicated by a tubo-ovarian abscess; and peripheral neuropathy.
2007 © John G. Bartlett, M.D. All rights reserved.4

Chapter 1: Natural History and Classification

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