Revised surveillance case definition for HIV infection--United States, 2014

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Surveillance

Background:

• Existing surveillance case definitions for human immunodeficiency virus (HIV) infection required revision to align with contemporary diagnostic advancements.
• Previous definitions presented challenges in uniformly classifying cases across different age groups and diagnostic methodologies.

Purpose of the Study:

• To introduce a unified, revised surveillance case definition for HIV infection applicable to all age groups.
• To enhance the accuracy and practicality of HIV surveillance by incorporating updated laboratory criteria and simplifying clinical reporting requirements.

Main Methods:

• Extensive consultation and peer review process involving the CDC and the Council of State and Territorial Epidemiologists.
• Revision of laboratory criteria to include multitest algorithms, differentiation of HIV-1/HIV-2, and recognition of early HIV infection (Stage 0).
• Simplification of clinical criteria by removing the need for laboratory test information and differentiating opportunistic illnesses.

Main Results:

• A single, comprehensive surveillance case definition for HIV infection has been established for all ages.
• New staging system (0-3) accommodates early infection and simplifies Acquired Immunodeficiency Syndrome (AIDS) classification.
• Revised criteria improve the practicality of case definition for population-level surveillance and planning.

Conclusions:

• The revised HIV surveillance case definition is essential for accurate monitoring of the HIV epidemic.
• Implementation of the new definition by all states and territories is recommended for effective HIV prevention and care planning.
• The updated definition supports a more robust understanding of the HIV burden at a population level.