Clinical Categories for Children Aged < 13 Years With HIV Infection
Clinical Categories for Children Aged < 13 Years With HIV Infection
| Category N: Not symptomatic |
| Children who have no symptoms or signs considered to result from HIV infection or who have only 1 of the conditions listed in category A |
| Category A: Mildly symptomatic |
| Children with ≥ 2 of the conditions listed below but none of the conditions listed in category B or C: |
| Dermatitis |
| Hepatomegaly |
| Lymphadenopathy (≥ 0.5 cm at > 2 sites; bilateral = 1 site) |
| Parotitis |
| Recurrent or persistent upper respiratory tract infection, sinusitis, or otitis media |
| Splenomegaly |
| Category B: Moderately symptomatic |
| Children with symptomatic conditions attributed to HIV infection beyond those listed in category A but not among those listed in category C; conditions in category B include but are not limited to the following: |
| Anemia (hemoglobin < 8 g/dL [< 80 g/L]), neutropenia (< 1,000/mcL [< 1 × 109/L]), or thrombocytopenia (< 100,000/mcL [< 100 × 109/L]) persisting ≥ 30 days |
| Bacterial meningitis, pneumonia, or sepsis (single episode) |
| Candidiasis, oropharyngeal (thrush), persisting (> 2 months) in children > 6 months of age |
| Cardiomyopathy |
| Cytomegalovirus infection with onset before 1 month of age |
| Diarrhea, recurrent or chronic |
| Hepatitis |
| Herpes zoster (shingles) involving ≥ 2 distinct episodes or > 1 dermatome |
| HSV stomatitis, recurrent (> 2 episodes within 1 year) |
| HSV bronchitis, pneumonitis, or esophagitis with onset before 1 month of age |
| Leiomyosarcoma |
| Lymphoid interstitial pneumonitis or pulmonary lymphoid hyperplasia complex |
| Nephropathy |
| Nocardiosis |
| Persistent fever (lasting > 1 month) |
| Toxoplasmosis with onset before 1 month of age |
| Varicella, disseminated (complicated chickenpox) |
| Category C: Severely symptomatic (stage 3–defining opportunistic infections) |
| Children with ≥ 1 of the following conditions: |
| Serious bacterial infections, multiple or recurrent (ie, any combination of ≥ 2 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) in a child < 6 years of age |
| Candidiasis, esophageal or pulmonary (bronchi, trachea, lungs) |
| Cervical cancer, invasive, in a child or adolescent ≥ 6 years of age |
| Coccidioidomycosis, disseminated (at a site other than or in addition to the lungs or cervical or hilar lymph nodes) |
| Cryptococcosis, extrapulmonary |
| Cryptosporidiosis (chronic intestinal) or isosporiasis (chronic intestinal) with diarrhea persisting > 1 month |
| Cytomegalovirus disease with onset of symptoms at age > 1 month (at a site other than the liver, spleen, or lymph nodes) |
| Cytomegalovirus retinitis (with loss of vision) |
| Encephalopathy (≥ 1 of the following progressive findings present for ≥ 2 months in the absence of a concurrent illness other than HIV infection that could explain the findings):
|
| Histoplasmosis, disseminated (at a site other than or in addition to the lungs or cervical or hilar lymph nodes) |
| HSV infection causing a mucocutaneous ulcer persisting for > 1 month or HSV bronchitis, pneumonitis, or esophagitis for any duration affecting a child > 1 month of age |
| Kaposi sarcoma |
| Lymphoma, primary, in the brain |
| Lymphoma: Small, noncleaved cell lymphoma (Burkitt), or immunoblastic or large-cell lymphoma of B-cell or unknown immunologic phenotype |
| Mycobacterium tuberculosis, pulmonary, disseminated, or extrapulmonary (at any site) |
| Mycobacterium avium complex, Mycobacterium kansasii, or other species or unidentified species, disseminated or extrapulmonary |
| Pneumocystis jirovecii pneumonia |
| Pneumonia, recurrent, in children or adolescents ≥ 6 years of age |
| Progressive multifocal leukoencephalopathy |
| Salmonella (nontyphoid) septicemia, recurrent |
| Toxoplasmosis of the brain with onset at > 1 month of age |
| Wasting syndrome in the absence of a concurrent illness (other than HIV infection) that could explain any one of the following 3 findings: plus 1 of the following: |
| HSV = herpes simplex virus. |
| Adapted from Centers for Disease Control and Prevention: Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged < 18 months and for HIV infection and AIDS among children aged 18 months to < 13 years of age—United States, 2008. Morbidity and Mortality Weekly Report 57(RR-10):1–13, 2008; and Centers for Disease Control and Prevention: Revised surveillance case definition for HIV infection–United States, 2014. Morbidity and Mortality Weekly Report 63(RR-3):1–10, 2014. |