cdcclassificationsystemforhivinchildren.docVIP

CDC CLASSIFICATION SYSTEM FOR HIV IN CHILDREN UNDER 13 YEARS OF AGE Diagnosis Classification of HIV Infection--Using the diagnosis classification definitions on the reverse side of this form, check (x) one box below. HIV Disease/AIDS ** Perinatally Exposed (Prefix E) Seroreverter (SR) ** If Perinatally Exposed is checked, the remainder of this form does not need to be completed until HIV status is determined at 18 months of age. The form does still need to be signed and dated by the Physician/Primary Care Practitioner. Once positive HIV status is determined, a new CDC Classification form must be completed. Immunologic Category Definitions--Based on the CD4 count and/or percentage, determine the immunologic category (e.g., 1, 2, or 3). IMMUNOLOGIC CATEGORY* AGE OF CHILD 12 months 1-5 years 6-12 years ?L (%) ?L (%) ?L (%) 1. No evidence of suppression ?1,500 (?25) ?1,000 (?25) ?500 (?25) 2. Evidence of moderate suppression 750-1,499 (15-24) 500-999 (15-24) 200-499 (15-24) 3. Severe suppression 750 (15) 500 (15) 200 (15) If the CD4+ count and the CD4+ percent indicate different classification categories, the child should be classified into the more severe category. Pediatric Classification of HIV Infection--Using the attached Clinical Category definitions, determine and circle one clinical category below. Add Prefix E for perinatally exposed children until their HIV status is confirmed (e.g., A1E). Clinical Categories (Circle One) (See attachment) Immunologic Categories (see chart above) N: No signs/ symptoms A: Mild signs/ symptoms B: Moderate signs/ symptoms C: Severe signs/ symptoms 1. No evidence of suppression N1 A1 B1 C1 2. Evidence of moderate suppression N2 A2 B2 C2 3. Severe suppression N3 A3 B3 C3 I accept full professional responsibility for this clients care. This client is stable and appropriate for home care. I will work closely with the MCWP Case Managers in meeting