Substance Abuse Treatment for Persons With HIV/AIDS
Treatment Improvement Protocol (TIP) Series 37

Category A

Category A consists of one or more of the conditions listed below in an adolescent or adult (> 13 years) with documented HIV infection. Conditions listed in Categories B and C must not have occurred.

• Asymptomatic HIV infection
• Persistent generalized lymphadenopathy
• Acute (primary) HIV infection with accompanying illness or history of acute HIV infection

Category B

Category B consists of symptomatic conditions in an HIV-infected adolescent or adult that are not included among conditions listed in clinical Category C and that meet at least one of the following criteria:

• The conditions are attributed to HIV infection or indicate a defect in cell-mediated immunity
• The conditions are considered by physicians to have a clinical course or to require management that is complicated by HIV infection. Examples of conditions in clinical Category B include, but are not limited to
  • Bacillary angiomatosis
  • Candidiasis, oropharyngeal (thrush)
  • Candidiasis, vulvovaginal: 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 lasting >1 month
  • Hairy leukoplakia, oral
  • Herpes zoster (shingles), involving at least two distinct episodes or more than one dermatome
  • Idiopathic thrombocytopenic purpura
  • Listeriosis
  • Pelvic inflammatory disease, particularly if complicated by tubo-ovarian abscess
  • Peripheral neuropathy

For classification purposes, Category B conditions take precedence over those in Category A. For example, someone previously treated for oral or persistent vaginal candidiasis (and who has not developed a Category C disease) but who is now asymptomatic should be classified in clinical Category B.

Category C

Category C includes the clinical conditions listed in the AIDS surveillance case definition (below). For classification purposes, once a Category C condition occurs, the person will remain in Category C.

• Candidiasis of bronchi, trachea, or lungs
• Candidiasis, esophageal
• Cervical cancer, invasive*
• Coccidioidomycosis, disseminated or extrapulmonary
• Cryptococcosis, extrapulmonary
• Cryptosporidiosis, chronic intestinal (>1 month's duration)
• Cytomegalovirus disease (other than liver, spleen, or nodes)
• Cytomegalovirus retinitis (with loss of vision)
• Encephalopathy, HIV-related
• Herpes simplex: chronic ulcer(s) (>1 month's duration); or bronchitis, pneumonitis, or esophagitis
• Histoplasmosis, disseminated or extrapulmonary
• Isosporiasis, chronic intestinal (>1 month's duration)
• Kaposi's sarcoma
• Lymphoma, Burkitt's (or equivalent term)
• Lymphoma, immunoblastic (or equivalent term)
• Lymphoma, primary, of brain
• Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary
• Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)
• Mycobacterium, other species or unidentified species, disseminated or extrapulmonary
• Pneumocystis carinii pneumonia
• Pneumonia, recurrent**
• Progressive multifocal leukoencephalopathy
• Pulmonary pneumonia
• Salmonella septicemia, recurrent
• Toxoplasmosis of brain
• Wasting syndrome due to AIDS

*This expanded definition requires laboratory confirmation of HIV infection in persons with a CD4+T lymphocyte count of fewer than 200 cells/mL or with an added clinical condition.

**Added as AIDS-defining illness in the 1993 expansion of the AIDS surveillance case definition, when occurring in persons with HIV infection.

Source: Castro et al., 1992.