HUMAN IMMUNODEFICIENCY VIRUS (HIV) NON-IMMEDIATE NOTIFICATION STD PROGRAM. Version

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1 1 HUMAN IMMUNODEFICIENCY VIRUS (HIV) NON-IMMEDIATE NOTIFICATION STD PROGRAM Event Name: Event Time Period: ADULT HIV 900 (AIDS.gov 12/31/2015) HIV Lifelong HIV (human immunodeficiency virus) is a retrovirus with two serologically and geographically distinct species: HIV- 1 and HIV-2. It is spread via person-to-person transmission through: sexual contact, the use of HIV-contaminated needles and syringes, vertical transmission from mother to infant, or the transfusion of infected blood or its components. If left untreated, HIV can progress to the disease AIDS (acquired immunodeficiency syndrome). Unlike some other viruses, the human body cannot get rid of HIV completely. HIV attacks the body s immune system, specifically the CD4 cells (T cells). If left untreated, HIV reduces the number of CD4 cells in the body, making the person more likely to get infections or infection-related cancers. These opportunistic infections or cancers take advantage of the weakened immune system and signal that the person has AIDS (the advanced stage of HIV infection). The incubation period is variable, although the time from infection to the development of detectable antibodies is generally less than one month. The time from HIV infection to diagnosis of AIDS, in the absence of antiretroviral treatment, has an observed range less than 1 year to 15 years or longer, with an average of about ten years from infection to an AIDS diagnosis. Positive HIV 1, Positive HIV 2, or Positive (Undifferentiated) HIV result from a differentiating immunoassay, Western Blot, IFA, or culture OR Positive/Detected Qualitative HIV NAT (DNA or RNA) OR Quantitative HIV NAT (detectable viral load assay) Probable Complete CRF received with MD confirmed diagnosis, no confirmatory lab Positive Ag/Ab screen, Positive EIA, Positive p24ag, undetectable viral load, or CD4 Revoked Inappropriately created case, not an MA case, cancer, CD4 only PEDIATRIC HIV- 900P <13 years old Probable Revoked *If case is less than 13 years old, alert the HIV liaison Two Positive HIV virologic test (HIV 1 NAT, HIV 1 p24, culture) results from 2 different specimens obtained on different dates Single Positive HIV virologic test (HIV 1 NAT, HIV 1 p24, culture) Positive Ab in <18 month olds) Inappropriately created case, not an MA case, cancer

2 2 ADULT AIDS (AIDS.gov 12/31/2015) AIDS stands for acquired immunodeficiency syndrome. AIDS is the advanced stage of HIV infection, and not everyone who has HIV advances to this stage. AIDS is the stage of infection that occurs when your immune system is compromised and you become vulnerable to opportunistic infections. When your CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed to AIDS (rmal CD4 counts are between 500 and 1,600 cells/mm3). You can also be diagnosed with AIDS if you develop one or more opportunistic infections, regardless of your CD4 count. evidence of HIV and complete CRF received AND CD4 absolute count <200 (or in absence of CD4 absolute count, CD4 percent below 14%) AND/OR an opportunistic infection diagnosis Probable Complete CRF received with MD confirmed diagnosis, no confirmatory lab CD4 absolute count <200 (or in absence of CD4 absolute count, CD4 percent below 14%) Revoked Inappropriately created case, not an MA case, cancer, CD4 only PEDIATRIC AIDS 950P <13 years old Probable Revoked *If case is less than 13 years old, alert the HIV liaison See case classification for adult AIDS See case classification for adult AIDS See case classification for adult AIDS Inappropriately created case, not an MA case, cancer

3 Report Type Test Type Source Result Laboratory report HIV-1/2 Ab/Ag screen (4 th gen) Blood, serum, saliva Positive, Reactive 3 New event? Data Entry Select: HIV 1+2 Ab HIV1 p24 Ag: ACnc : Pt : Ser : Ord : EIA HIV-1/2 Ag/Ab screening HIV 1 Ab+Ag [Presence] in Serum HIV-1/2 Ag/Ab screening Laboratory report EIA, ELISA Blood, serum, saliva Positive Select: HIV 1+2 Ab [Presence]: ACnc : Pt : XXX : Ord HIV-1/2 IA (EIA or Other) HIV 1+O+2 Ab [Presence] : ACnc : Ser/Plas : Ord HIV-1/2 IA (EIA or Other) HIV 1 Ab [Units/volume] : ACnc : Pt : Ser : Qn : EIA HIV-1 IA (EIA or Other) HIV 1 Ab : ACnc : Pt : Body fld : QI : Ord HIV-1 IA (EIA or Other) HIV 2 Ab [Presence] : ACnc: Pt : Ser : QI : Ord : EIA HIV-2 IA (EIA or Other) Laboratory report HIV-1 p24 Antigen Blood, serum, saliva Positive Select: HIV 1 p24 Ag [Presence] : ACnc : Pt : CSF : Ord HIV-1 p24 Antigen HIV 1 P24 Ag : ACnc : Pt : Ser : QI : Ord : EIA HIV-1 p24 Antigen HIV 1 P24 Ag [Mass/volume] : MCnc : Ser : Qn : EIA HIV-1 p24 Antigen HIV 1 P24 Ag Ser Ql HIV-1 p24 Antigen HIV 1 P24 Ag : ACnc : Pt : CSF : Qn HIV-1 p24 Antigen

4 Report Type Test Type Source Result Laboratory report Laboratory report Laboratory report HIV-1/2 Type- Differentiating Immunoassay Blood, serum, saliva HIV 1 RNA [Units/volume] (viral load) (Quant bdna) in Plasma by Probe and signal amplification method 4 Positive (undifferentiated HIV), Human Immunodeficiency Virus, Human Immunodeficiency Virus Type 1, Human Immunodeficiency Virus Type 2, Human Immunodeficiency Virus 2 positive with HIV-1 cross reactivity Indeterminate, Human Immunodeficiency Virus 1 Indeterminate, Human Immunodeficiency Virus 2 Indeterminate New event? Data Entry Any of the above, negative, inconclusive, not detected Select: HIV 1 and 2 Ab [Identifier] in Serum or Plasma by Rapid immunoassay Multispot type differentiating HIV 1 and 2 Ab in Serum/Plasma/Blood by Rapid immunoassay Geenius Assay type differentiating HIV 1 Ab [Presence] in Serum, Plasma or Blood by Rapid immunoassay Geenius Analyte HIV-1 HIV 2 Ab [Presence] in Serum, Plasma or Blood by Rapid immunoassay Geenius Analyte HIV-2 Positive (undifferentiated HIV), Western Blot, Blood, serum, Human Immunodeficiency Virus, IFA saliva Human Immunodeficiency Virus Type 1, Human Immunodeficiency Virus Type 2 Select: HIV 1 & 2 Ab band pattern [interpretation] : Imp : Pt : Ser : m : IB Differentiating Western blot HIV 1 Ab [Presence] : ACnc : Pt : Body fld : Ord : IB HIV-1 Western Blot HIV 2 IgG Ab [Presence] : ACnc: Pt : Ser : Ord : IB HIV-2 Western Blot HIV 2 Ab [Presence] : ACnc : Pt: Ser : Ord : IB HIV-2 Western Blot HIV 1 Ab: ACnc: Pt: Ser: Ord: IF HIV-1 Immunofluorescence HIV-1 RNA Quantitative NAAT viral load Blood, serum, saliva A numeric value by itself, or a numeric value with a = or a > symbol Numeric value with a less than < symbol indicating an undetectable viral load Any of the above Select: HIV 1 RNA [#/volume] (viral load) : NCnc : Pt : XXX : Probe.amp.tar HIV 1 RNA [Log #/volume] (viral load) : LnCnc : Pt : XXX : Qn : Probe.amp.tar HIV-1 viral load (Quantitative) HIV-1 viral load log copies(quantitative) HIV-1 viral load copies(quantitative)

5 5 New Data Report Type Test Type Source Result event? Entry Detected, Trace, Positive HIV-1 or HIV-2 Laboratory report Qualitative NAT Blood, serum, saliva Undetectable, t detected, Negative, (DNA or RNA) Indeterminate existing event HIV-1 viral load (detected or Select: HIV 1 RNA [#/volume] (viral load) : NCnc : Pt : XXX : Probe.amp.tar trace)(qualitative) HIV 1 RNA [Log #/volume] (viral load) : LnCnc : Pt : XXX : Qn : HIV-1 viral load (detected or Probe.amp.tar trace)(qualitative) HIV 1 RNA [Units/volume] (viral load) (Quant bdna) in Plasma by HIV-1 viral load (detected or Probe and signal amplification method trace)(qualitative) HIV 1 RNA [Presence] : ACnc : Pt : XXX : Ord : Probe.amp.tar HIV-1 RNA/DNA NAT (Qualitative) Laboratory report HIV 1 DNA [Presence] : ACnc : Pt : Ser/Plas : Probe.amp.tar HIV-1 RNA/DNA NAT (Qualitative) HIV 2 DNA Bld Ql PCR HIV-2 RNA/DNA NAT (Qualitative) HIV 2 DNA [Presence] : ACnc : Pt : XXX : Probe.amp.tar HIV-2 RNA/DNA NAT (Qualitative) CD4 absolute count CD4 percent Blood, serum, saliva Numeric result only Select: Deprecated CD4 cells [#/volume]: NCnc : Pt: XXX : Qn CD4 absolute count Deprecated CD4 cells [/100 Cells] : NFr : Pt: XXX : Qn CD4 percent existing event Laboratory report Culture Blood, serum, saliva Human Immunodeficiency Virus, Human Immunodeficiency Virus Type 1, Human Immunodeficiency Virus Type 2 Select: Virus identified : PrId : Pt : xxx : m : Virus culture Virus culture Microorganism identified : PrId : Pt : xxx : m : Culture Microorganism culture existing event

6 6 ADDITIONAL NOTES: Incident case: A newly reported individual living in Massachusetts, reported within the calendar year, with a diagnosis date within that calendar year Prevalent case: A newly reported individual living in Massachusetts, reported within the calendar year, with a diagnosis date outside of that calendar year Opportunistic infections: Bacterial infection, multiple or recurrent (including Salmonella septicemia) Candidiasis of the lung Candidiasis, Esophogeal Cervical cancer Coccidioidomycosis Cryptococcosis Cryptosporidiosis Cytomegalovirus disease Cytomegalovirus retinitis HIV encephalopathy Herpes simplex Histoplasmosis Isosporiasis Kaposi s sarcoma Lymphoid interstitial pneumonitis Lymphoma, Burkitt s Lymphoma, immunoblastic Lymphoma, primary in brain Mycobacterium avium complex M. Tuberculosis, pulmonary M. Tuberculosis, disseminated Mycobacterium, other species Pneumocystis pneumonia (PCP) Pneumonia (any organism), recurrent Progressive leukoencephalopathy Salmonella septicemia Toxoplasmosis of brain HIV Wasting Syndrome

Title: Revision of the Surveillance Case Definition for HIV Infection and AIDS Among children age > 18 months but < 13 years

06-ID-02 Committee: Infectious Disease Title: Revision of the Surveillance Case Definition for HIV Infection and AIDS Among children age > 18 months but < 13 years Statement of problem: Advances in HIV