A. All patients aged 13 years and older with a diagnosis of HIV/AIDS, with at least two medical visits during the measurement year, with at least 90 days between each visit, who have a history of a CD4 count less than or equal to 500 cells/mm3; and
B. All patients aged 13 years and older with a diagnosis of HIV/AIDS, with at least two medical visits during the measurement year, with at least 90 days between each visit, who have a history an AIDS-defining illness**, regardless of CD4 count; and
C. All patients with a diagnosis of HIV/AIDS, with at least two medical visits during the measurement year, with at least 90 days between each visit, who are pregnant, regardless of CD4 count or age.
**The most commonly used case definition for AIDS is the 1993 Revised Surveillance Case Definition from the CDC. It includes: Candidiasis of bronchi, trachea, or lungs; candidiasis, esophageal; cervical cancer, invasive; coccidiodomycosis, disseminated or extrapulmonary; cryptococcosis, extrapulmonary; crytosporidiosis, chronic intestinal (greater than 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) (greater than 1 month’s duration); or bronchitis, pneumonitis, or esophagitis; histoplasmosis, disseminated or extrapulmonary; isosporiasis, chronic intestinal (greater than 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; salmonella septicemia, recurrent; toxoplasmosis of brain; wasting syndrome due to HIV. (Aberg, 2009; National Center for Infectious Diseases Division of HIV/AIDS)
Definition of “Medical Visit” - any visit with a health care professional who provides routine primary care for the patient with HIV/AIDS (may be but is not limited to a primary care clinician, ob/gyn, pediatrician, infectious diseases specialist)
Note: For potent antiretroviral therapy recommendations refer to current DHHS guidelines available at www.aids.gov
Aberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, Oleske JM, Currier JS, Gallant JE; HIV Medicine Association of the Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Sep 1;49(5):651-81. Available at http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/idsahivprimarycare2009.pdf. Accessed May 25, 2012.
National Center for Infectious Diseases Division of HIV/AIDS. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMRW Recomm Rep. 1992;41(RR-17):1-19.
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