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Medical Forum / Diseases and Disorders / AIDS / December 2004

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CDC REVISED GUIDELINE - How mortality figures were distorted

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PaulKing - 08 Dec 2004 06:53 GMT
http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm

1993 Revised Classification System for HIV Infection and Expanded
Surveillance Case Definition for AIDS Among Adolescents and Adults

Summary

CDC has revised the classification system for HIV infection to emphasize
the clinical importance of the CD4+ T-lymphocyte count in the
categorization of HIV-related clinical conditions. This classification
system replaces the system published by CDC in 1986 (1) and is primarily
intended for use in public health practice. Consistent with the 1993
revised classification system, CDC has also expanded the AIDS surveillance
case definition to include all HIV-infected persons who have less than 200
CD4+ T-lymphocytes/uL, or a CD4+ T-lymphocyte percentage of total
lymphocytes of less than 14. This expansion includes the addition of three
clinical conditions

*   

pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer
-- and retains the 23 clinical conditions in the AIDS surveillance case
definition published in 1987 (2); it is to be used by all states for AIDS
case reporting effective January 1, 1993.
PaulKing - 08 Dec 2004 07:03 GMT
In short, when the changing definition of "AIDS" (see the CDC's MMWR 1992;
41:1-19)  was compared to the old pre-1993 version of the definition in
which people were
diagnosed SOLELY upon clinical considerations (i.e. ACTUAL sicknesses),
researchers found, lo and behold, an increase in survival of almost 2.5
times just by controlling for the revised definition!

They published their findings in the VERY mainstream Journal of the
American Medical Association
in 1994 (Vella S, et al. JAMA 1994; 271:1197-9).
 
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