Abstract

PIP: This article presents a classification system for patients with the spectrum of clinical and laboratory findings attributable to human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). This classification system is primarily for public health purposes, including disease reporting and surveillance, epidemiologic studies, prevention and control activities, and public health policy and planning. The system classifies the manifestations of HTLV-III/LAV infection into 4 groups: I) patients with transient signs and symptoms that appear at the time of, or shortly after, initial infection with HTLV-III/LAV as identified by laboratory studies; II) patients with no signs or symptoms of HTLV-III/LAV infection, who in turn can be subclassified on the basis of whether hematologic and/or immunologic studies have been done and whether results are abnormal; III) patients with persistent generalized lymphadenopathy at 2 or more extra-inguinal sites persisting for more than 3 months in the absence of a condition other than HTLV-III/LAV infection to explain these findings; and IV) patients with clinical symptoms and signs of HTLV-III/LAV infection other than or in addition to lymphadenopathy. Patients in Group IV are further categorized into 5 subgroups: A) constitutional disease, B) neurologic disease, C) secondary infectious disease, D) secondary cancers, and E) other conditions resulting from HTLV-III/LAV infection. This classificatory system will require periodic revision as new information about HTLV-III/LAV infection is accumulated. Patients whose clinical presentations fulfill the surveillance definition of acquired immunedeficiency syndrome (AIDS) should be classified in Group IV.