Abstract

PIP: The positive predictive values for HIV seropositivity are compared using WHO and US Centers for Disease Control (CDC) clinical case definitions of acquired immunodeficiency syndrome (AIDS), for cases in Rwanda, Africa. It is postulated that the article by Colebunders and co-workers should encourage clinicians and epidemiologists working in Africa to adopt the World Health Organization's provisional clinical case definition for AIDS. Although the predictive value for HIV seropositivity calculated in urban-based adults, as measured by the 2 different criteria, is comparable, (both criteria yield a 93% positive predictive value), this high % is not reached for cases of AIDS diagnosed for rural adults or urban-based children, using the WHO criteria. These data confirm the opinion of Colebunders and co-workers that regional variations in the prevalence of HIV infection can interfere with the positive predictive value for HIV seropositivity of this definition. Workers in other countries should test the validity of the WHO criteria in their own settings and evaluate the WHO case definition adapted to pediatric AIDS in Africa.