CDC announces newly revised surveillance case definition for HIV

The Centers for Disease Control and Prevention (CDC) has published a revised “surveillance case definition” for HIV infection. A surveillance case definition is a set of uniform criteria that is then used to define a disease, and guides CDC oversight on a particular disease. This report, published in the Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports, updates the definition published in 2008.

CDC has revised and combined the surveillance case definition for HIV infection into a single case definition that can be applied to all ages. The revisions were primarily carried out due to recent changes in diagnostic criteria. Some of the other changes in the case definition include:

• The laboratory criteria for defining a confirmed case now accommodates new multi-test algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection, and for recognizing early HIV infection.
   
• A confirmed case can now be classified in one of five HIV infection stages—0,1,2,3 or unknown; early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as “stage 0”, whereas AIDS is classified as “stage 3”.

The surveillance case definition is intended for monitoring the HIV burden in the United States and planning for prevention and care on a population level. This case definition’s staging system allows for health departments to evaluate prevention and care. These can be measured by analyzing the stage of disease at diagnosis and how rapidly people with HIV infection progress to more advanced stages. For various reasons, it would be inappropriate for clinicians to use the surveillance staging system as a guide to manage patients.

CDC will use the revised case definition in its national HIV surveillance system (NHSS). The system monitors early diagnosis, care, and viral suppression across the country, to facilitate prevention of HIV transmission, morbidity, and mortality.

CDC provides updates regarding the NHSS, tools, and guidance to state and local HIV surveillance programs. The revised definition will improve the identification and characterization of cases and ultimately help strengthen the quality of our national HIV data.

Irene Hall, has a PhD and is co-termed FACE and carries the title of Chief, HIV Incidence and Case Surveillance Branch in the Division of HIV/AIDS Prevention for the National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC).

by Irene Hall, Centers for Disease Control

The Gayly – May 6, 2014 @ 9:30am