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DDS Medical Advisory #97-3

Attachment A

State of Connecticut Department of Public Health

Who is counted as an AIDS case?

Per criteria defined by the Centers for Disease Control and Prevention (CDC) in order to be reported as an AIDS case, a person must be diagnosed with one or more of the "AIDS indicator" diseases (e.g. Carposis's Sarcoma, Pneumocystis pneumonia, etc.) or have HIV-related severe immunosuppression (CD4 T-lymphocyte count of less than 200 cells/uL or a CD4 T-lymphocyte percentage of total lymphocytes of less than 14); pulmonary tuberculosis (TB), recurrent pneumonia, or invasive cervical cancer

Only people with AIDS as defined by the CDC are reportable in Connecticut. HIV infection without AIDS is not a reportable condition in adults; however, it is reportable in children under thirteen years of age. The number of people who meet the AIDS case definition should not be used as the sole indicator of the impact of HIV infection, since it provides a "lagging indicator" of the patterns of HIV transmission. Because the latency period between infection and development of disease is 8-10 years or longer, AIDS cases occurring now are indicative of HIV infections acquired 8-10 years ago.

What is the difference between the number of cases reported in a year and the number of cases diagnosed?

Every year, the AIDS Surveillance Program receives case reports from health care providers - the number of case reports received in a year constitutes the "reported" cases. Once the year is over, the number of cases reported for that year does not increase. On the other hand, every year a certain number of people are diagnosed with AIDS - these are the diagnosed, or incident, cases for the year. Many cases are reported several months after they are diagnosed; consequently, the number of cases diagnosed in any given year will increase even after the year is over. This means that the most recent year's diagnosed cases will not be complete until reporting is complete.. Approximately 65-70% of cases are reported within 6 months of diagnosis.

When the number of AIDS cases is broken down by year by the AIDS Surveillance Program, it is often broken down in terms of diagnosed cases per year (unless a specific request is made for the number of reported cases), since this distribution better reflects occurrence of AIDS in patients over time.

Who is included when considering the number of cases in the state or in a particular city or county?

People are included in the AIDS database if they are residents of Connecticut at the time of their diagnosis. This means that people initially diagnosed in a different state are not reported in Connecticut, even if they live here now. For cases reported from prisons, the residence at the time of diagnosis is not the prison, but the person's recent address.