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Saturday, November 22, 2008
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THE DESIGNATION
AIDS IS A SURVEILLANCE
TOOL
Surveillance definitions of AIDS have
proven useful epidemiologically to track and quantify the recent epidemic of HIV-mediated
immunosuppression and its manifestations. However, AIDS represents only the end
stage of a continuous, progressive pathogenic process, beginning with primary
infection with HIV, continuing with a chronic phase that is usually asymptomatic,
leading to progressively severe symptoms and, ultimately, profound immunodeficiency
and opportunistic infections and neoplasms (Fauci, 1993a). In clinical practice,
symptomatology and measurements of immune function, notably levels of CD4+ T lymphocytes,
are used to guide the treatment of HIV-infected persons rather than an all-or-nothing
paradigm of AIDS/non-AIDS (CDC, 1992a; Sande et al., 1993; Volberding and Graham,
1994).
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