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  1. 1
    067721

    Human immunodeficiency virus (HIV) infection codes and new codes for Kaposi's sarcoma. Official authorized addenda ICD-9-CM (revision no. 2). Effective October 1, 1991.

    United States. National Center for Health Statistics [NCHS]

    MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT. 1991 Jul 26; 40(RR-9):1-19.

    The addenda for Volumes 1 and 2 of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) were reported by the Collaborating Center for Classification of Diseases for North America at the National Center for Health Statistics. This was the second revision of these codes for the classification of HIV infection. THe addenda, effective October 1, 1991, replace the addendum containing codes for human immunodeficiency virus (HIV) infection that went into effect January 1, 1988. The structure of the classification, the codes within the classification, and the use of the codes remained the same. 3 basic modifications were accepted. A new 3-digit category was created for Kaposi's sarcoma; several new clinical conditions were added (acute or subacute endocarditis, microsporidiosis, acute or subacute myocarditis, bacterial and pneumococcal pneumonia, histiocytic or large cell lymphoma, secondary cardiomyopathy and nephritis and nephropathy); and several categories of HIV manifestations were expanded to include similar conditions (viral pneumonia, encephalitis, encephalomyelitis and myelitis). These modifications will improve the accuracy of reporting and allow public health officials, clinical researchers, and agencies which finance health care to monitor diagnoses of AIDS and other manifestations of HIV infection. HIV infection is divided into 3 categories: HIV infection with specified secondary infections or malignant neoplasms, or AIDS; HIV infection with other specified manifestations; and other HIV infections not classifiable above. AIDS is not synonymous with HIV infection or with such terms as pre-AIDS or AIDS-related complex. To use these codes correctly, the physician must provide complete information and state the relationship between HIV infection and other conditions.
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  2. 2
    074583

    Some clinical aspects of HIV infection in Africa.

    Harries A

    AFRICA HEALTH. 1992 Jul; 14(5):10-1.

    An update on clinical aspects of HIV in africa highlights new proposed clinical definitions of adult AIDS and of tuberculosis in HIV+ adults, and staging of adult HIV infection. The 1986 WHO clinical definition of AIDS has been widely used in Africa, but now research suggests that this definition has several limitations: the definition will pick up several unrelated diseases such as diabetes mellitus and renal failure. It does not ascertain cases of AIDS marked by nonopportunistic infections. Most persons with pulmonary tuberculosis may be wrongly diagnosed with AIDS by this definition. The study showed that the WHO clinical definition has good specificity and positive predictive value for HIV+ people, but its positive predictive value fell to 30% in identifying people with AIDS in Africa. New definitions should take into account any serious morbidity, tuberculosis, neurological disease, both endemic localized Kaposi's, and aggressive typical Kaposi's sarcoma, and HIV serological testing. Tuberculosis is a problem because few HIV+ people suspected of having pulmonary TB (sputum-negative TB) actually have it based on bronchoscopy, while HIV+ persons with TB experience high mortality, often from pyogenic bacteremia. HIV+ persons with TB suffer high rates of relapse, possibly related to insufficient drug treatment or reinfection. 1 study showed that 6 months of isoniazid significantly improved incidence of TB over 30 months of follow-up. Staging of AIDS in Africa based on degree of immunosuppression was proposed as: 1) clinically inapparent HIV infection marked by pulmonary TB, soft tissue infections, and community acquired pneumonia; 2) lymphadenopathy, oral thrush, widespread pruritic maculopapular rash, herpes zoster, enteric illness, dysentery, and Kaposi's sarcoma; and 3) HIV wasting syndrome, chronic pulmonary disease, meningitis, and fever of unknown origin.
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  3. 3
    039735

    [Acquired immunodeficiency syndrome (AIDS): WHO meeting and consultation on the safety of blood and blood products] Syndrome d'immunodeficit acquis (SIDA): reunion et consultation de l'OMS sur la securite du sang et des produits sanguins.

    Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1986 May; 61(18):138-40.

    The World Health Organization (WHO) convened a meeting of experts on April 14-16, 1986, to review the available information on the safety of blood and blood products in relation to acquired immunodeficiency syndrome (AIDS). It was attended by over 100 participants from 34 countries and followed by a consultation which took into consideration previous recommendations, new information, and many different circumstances which exist regarding AIDS at the global level. This discussion reports the main conclusions and recommendations of the consultation. Tests to detect antibody to the AIDS virus now are available to assist in the elimination of potentially infectious units of blood and plasma, yet it is important to recognize that information and education remain crucial elements in any AIDS prevention program and that they continue to be relevant to the safety of blood and blood products. In that respect, measures to limit the transmission of LAV/HTLV-III by whatever means will be most effective in communities which are as well informed as possible about the disease, how it is transmitted, and how donors can assist in assuring a safe blood supply by being alert to donor suitability criteria. In some countries risk factors for AIDS have been identified in homosexual and bisexual men, intravenous drug abusers, and their sexual partners. Self-exclusion systems in which persons with risk factors refrain from giving blood, and blood screening programs for virus antibody have been effective in contributing to a safe blood supply. Experience also has shown that frequently when persons infected with the AIDS virus have donated blood, risk factors could later be identified, but many of those donors may not have recognized or acknowledged that they carried a risk. The value of specific screening and control measures which have been found useful in many developed countries should be assessed by other countries in the context of their overall health programs and the availability of human and material resources. Well-accepted general principles concerning the use of blood and blood products need to be emphasized since they can contribute to the control of AIDS. The most important principles are: strategies of health services such as improved antenatal care can reduce the demand for blood and should be encouraged; when appropriate and safer components and derivatives can be produced and are available, they are preferable to whole blood or plasma; and whole blood or plasma should be transfused only when medically justified. Decisions to institute laboratory screening of donors should be made with full awareness that there are several essential components of such a program. Information and education for donors about AIDS, its risk factors, and blood transmission is one of the basic considerations. Exclusion based on a current history of possible exposures to known risk factors as well as symptoms can help to reduce the number of infected donors.
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