Diagnosis Requires A Positive Result From An Initial Hiv...

TERMINOLOGY CLINICAL CLARIFICATION 1 †¢ Diagnosis requires a positive result from an initial HIV antibody or combination antigen/antibody test plus an accompanying or subsequent positive result from a supplemental HIV test different from the initial test 1 †¢ Current guidelines suggest using a Fourth generation assay that detects HIV p24 antigen AND HIV antibodies 19 o Positive results are confirmed by an HIV-1/HIV-2 differentiation immunoassay - If the differentiation immunoassay is indeterminate or negative, plasma HIV RNA level (HIVviralload) should be checked. o Note that these current guidelines differ from the classic approach of first testing with a third generation antibody test, an enzyme immunoassay (EIA), and then confirming†¦show more content†¦(2 or more episodes in 12 months) - Esophageal candidiasis - Invasive cervical carcinoma confirmed by biopsy - Disseminated or extra pulmonary coccidioidomycosis - Extrapulmonary cryptococcosis - Chronic intestinal cryptosporidiosis (1 month in duration) - Cytomegalovirus disease (other than liver, spleen, or nodes) - HIV-related encephalopathy - Herpes simplex virus characterized by chronic ulcers (1 month in duration), or bronchitis, pneumonitis, or esophagitis - Disseminated or extra pulmonary histoplasmosis - Chronic intestinal isosporiasis, (1 month in duration) - Kaposi sarcoma - Lymphoma (Burkitt, immunoblastic, or primary central nervous system) - Disseminated or extra pulmonary Mycobacterium avium complex (MAC) or Mycobacterium kansasii - Pulmonary or extrapulmonary Mycobacterium tuberculosis - Disseminated or extra pulmonary Mycobacterium, other species or unidentified species - Pneumocystisjiroveci (formerly carinii) pneumonia (PCP) - Progressive multifocalleukoencephalopathy (PML) - Recurrent (nontyphoid) Salmonella septicemia - Toxoplasmosis of brain - HIV wasting syndrome (involuntary weight loss 10% of baseline body weight) associated with either chronic diarrhea (two or more loose stools per day For 1 month) or chronic weakness and documented Fever For 1 month DIAGNOSIS CLINICAL PRESENTATION †¢ History o Greater than 50% with acute HIV infection develop symptoms, although timing and duration are variable 4 - Acute illness develops within 1-4 weeks