For better international "understanding" and to prevent misunderstandings, a classification system was devised in 1993 by the Centers for Disease Control (CDC) in the USA and the World Health Organization (WHO), which should allow a better classification of the severity of the disease, the determination of a possible start of therapy and a possible prognosis. This classification is still valid today, even though the prognosis, i.e. the probability of survival, has changed considerably over the years with the improvement of HIV therapy.
The coding is done with the letters A to C and the numbers 1 to 3.
The letters circumscribe the clinical categories:
A = asymptomatic HIV infection except for possible generalized lymph node swelling including acute HIV infection
B = List defined diseases with typical symptoms and or typical diseases that often occur in the context of HIV infection with damage to the immune system.
C = AIDS-defining diseases defined in a list
The numbers circumscribe ranges of a certain CD4 cell count (T-helper cells) in the blood:
1:> 500/µl CD4 cells
2: 200-500/µl CD4 cells
Acute HIV infection
Days to weeks after an infection with the HI virus, 40-90% of infected persons experience physical symptoms. Symptoms such as fatigue, fever, muscle and limb pain, swelling of the lymph nodes, skin rashes or diarrhea are difficult to distinguish from other viral illnesses such as flu-like infections.
An HIV infection can be detected with different test systems (HIV rapid tests, HIV self-tests, HIV single-subject tests). However, depending on the test procedure, several weeks (usually 6-12) can pass between infection and detectability. Direct virus detection by polymerase chain reaction (PCR) usually detects an infection earlier than an antibody/antigen test and is possible in specialized facilities.
Information on the topic "Possibilities of testing offer different institutions.
Symptom-free HIV infection
An HIV infection does not have to be accompanied by symptoms either in the acute phase directly after infection or in the chronic phase after the virus has established itself in the body. Only an HIV test or a direct virus detection can answer the question of a possible infection with the HI virus.
Being HIV-infected without having symptoms does not mean not being able to infect other people!
In recent years, there have been regular changes in the assessment of when drug therapy (ART = antiretroviral therapy) is necessary. In the meantime, however, the "early" use of tryptophan has become internationally accepted Initiation of ART after diagnosis for the most
HIV-infected people. ART with the aim of suppressing the HI virus replication can improve the immune system and
Prevent HIV-associated complications as well as the transmissibility of the virus to other people.
The decision for or against ART should be made together with an experienced treatment provider.
Symptomatic HIV infection
Symptomatic HIV infection, as defined by CDC Classification B, is the presence of symptoms or illnesses that are causally related to HIV infection but are not classified as full-blown AIDS.
These include oral hairy leukoplakia (OHL), fungal disease of the mouth, and peripheral nerve disease (peripheral polyneuropathy=PNP).
The most important therapeutic guidelines (u.a. DHHS, German-Austrian, EACS) recommend antiretroviral therapy for symptomatic HIV infection.
Full-blown AIDS (Acquired Immune Deficiency Syndrome), CDC Classification C, is defined as the occurrence of certain so-called AIDS-defining illnesses.
These include Kaposi's sarcoma, pneumocystis pneumonia, and fungal disease of the esophagus. In the United States, the term AIDS has been expanded to include a drop in the T-helper cell count to less than 200/µl.
As with symptomatic HIV infection , the main treatment guidelines (u.a. DHHS, German-Austrian, EACS) antiretroviral therapy at this stage of HIV infection.