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Updated January 30, 2011

Case 2: HIV Case Definition

Author: David H. Spach, MD

A 31-year-old HIV-infected woman has recently been diagnosed with HIV infection and she comes to the clinic for her first evaluation. She believes she was likely infected with HIV approximately 4 years ago. Three weeks prior to this visit, she had a Papanicolaou (Pap) smear result that showed severe cervical dysplasia and this Pap smear result prompted the HIV antibody testing. Her physical examination shows oral candidiasis and oral hairy leukoplakia. She does not have any other HIV-related manifestations and she has no history of HIV-related complications. Her CD4 count is 238 cells/mm3 (12%) and HIV RNA is 187,000 copies/ml.

According to the 2008 CDC case definition for HIV infection among adolescents and adults, which of the following statements is TRUE regarding the classification of this patient's HIV infection?

A The diagnosis of severe cervical dysplasia meets criteria for HIV infection, stage 4 (AIDS, severe immune suppression).
B The HIV RNA value of 187,000 copies/ml meets criteria for HIV infection, stage 2 (AIDS).
C The diagnosis of oral candidiasis meets criteria for HIV infection, stage 3 (AIDS).
D The CD4 percentage of 12% meets criteria for HIV infection, stage 3 (AIDS).