Patients with serologic evidence of infection with the human immunodeficiency virus (HIV) can be diagnosed as having acquired-immunodeficiency syndrome (AIDS) based upon "clinical" or "immunologic" criteria (see Table 52–1).
— Patients with AIDS diagnosed based on clinical criteria are classified as having "clinical AIDS."
— Patients with AIDS diagnosed based on a blood CD4 T cell count of less than 200/μL are classified as having "immunological AIDS."
Patients with HIV are living longer in the era of highly active antiretroviral therapy (HAART).
United Nations estimated that 30 to 35 million people worldwide were living with HIV infection in 2007, with the majority being infected by heterosexual contact.
TABLE 52–1DEFINITION OF AIDS IN THE UNITED STATES |Favorite Table|Download (.pdf) TABLE 52–1 DEFINITION OF AIDS IN THE UNITED STATES
|Clinical AIDS-defining conditions in persons infected with HIV |
| Opportunistic infections |
| Lymphomas (non-Hodgkin) |
| Kaposi sarcoma |
| Cervical cancer |
| Wasting syndrome |
| AIDS dementia syndrome |
| Recurrent bacteria pneumonia (≥2 episodes/yr) |
| Mycobacterium infections |
|Immunologic AIDS |
| CD4 cell counts <200/μL |
| CD4 percent of lymphocytes <14% |
ETIOLOGY AND PATHOGENESIS
Human Immunodeficiency Virus 1
The primary cause of AIDS is infection with HIV-1.
HIV-1 is a member of the Lentivirinae subfamily of retroviruses.
— Retroviruses are RNA viruses that induce a chronic cellular infection by converting their RNA genome into a DNA provirus that is integrated into the genome of the infected cell.
Infection by these lenetviruses is characterized by long periods of clinical latency followed by gradual onset of disease-related symptoms.
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