Introduction

Infection with HIV causes a spectrum of clinical problems beginning at the time of seroconversion (primary HIV) and terminating with AIDS and death. It is now recognised that it may take 10 years or more for AIDS to develop after seroconversion.

The Centers for Disease Control (CDC) in the USA developed the most widely used classification for HIV disease based on the presence of clinical symptoms and signs, the presence of certain conditions and investigative findings, the availability of HIV screening and the degree of immunosuppression as measured by the CD4 lymphocyte count. The infection is divided into four groups (Box 4.1):

Group I Primary HIV infection Group II Asymptomatic phase Group III Persistent generalised lymphadenopathy Group IV Symptomatic infection

Group IV is subdivided into several subgroups and some of these (groups IVA, B, C1 and D) are AIDS-defining conditions (Box 4.1).

In 1993 the CDC included all HIV-infected persons with CD4 lymphocyte counts of 500 200-499 as the findings are non-specific and the presence of lymphadenopathy due to HIV alone does not worsen the prognosis. The indications for a biopsy are the same in HIV and non-HIV-related conditions (Box 4.3).

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Source: Alder M.W.. ABC of AIDS. Fifth edition. —BMJ Publishing Group,2001. — 126 p.. 2001

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