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CONFUSED ABOUT YOUR ARTICLE (DEFINITION HIV VS AIDS 2009)
Feb 17, 2009

In your answr to a patient , you said that the current definition of AIDS is not reversible to HIV. It is my understanding that even if you have been diagnosed with AIDS, once you get better CD4 more than 200 and no opportunistic infections the definition of AIDS reverses to HIV. WEhen did this definition changed? Are you saying that even if a healthy HIV person with no opportunistic infections and CD4 of 1500 has AIDS? Please respond ASAP, since i am an educator

Response from Dr. Frascino

Hello HIV Educator,

"When did this definition change?" Actually the definition never changed. Apparently your understanding has been incorrect all along! Once someone has a diagnosis of AIDS, it is indeed absolutely irreversible, even if his CD4 count returns to 1,500!

Perhaps a little history will help clarify things. The term AIDS was coined in 1982 as an epidemiological tool to help us quantify and track the epidemic. Remember HIV had not yet been discovered, so there was absolutely no way to know whether someone was sick until they became deathly ill with opportunistic diseases. A person was diagnosed with AIDS if he developed one of a number of specific opportunistic infections or malignancies. These particular illnesses do not occur in folks with normal and healthy immune systems. After HIV was discovered and a test became available, being HIV-antibody positive became part of the definition of AIDS. In 1993 the CDC expanded the AIDS definition to include folks whose CD4 counts dropped to 200 or below.

To be quite honest the term AIDS really isn't all that useful anymore. If someone is HIV positive, he has HIV disease. HIV disease can range from asymptomatic to severely symptomatic. Antiretroviral drugs have restored many "AIDS" patients back to health. However, in the eyes of scientists, researchers, epidemiologists and organizations that track the pandemic, once someone has AIDS, he always has AIDS. But remember AIDS or HIV is not what really matters. Far more important is how well the HIV-infected person is doing now!

One more thing I should mention: We no longer use the term "full blown AIDS," because there is no such thing as "partially blown AIDS."

Hope that helps.

Dr. Bob



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