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April 15, 1988

Impact of the Revised AIDS Case Definition on AIDS Reporting in San Francisco

Author Affiliations

AIDS Office Department of Public Health San Francisco

AIDS Office Department of Public Health San Francisco

JAMA. 1988;259(15):2235. doi:10.1001/jama.1988.03720150017010

To the Editor.  —The Centers for Disease Control (CDC) recently revised the national case definition of acquired immunodeficiency syndrome (AIDS). The revision expanded the list of diseases indicative of AIDS to include human immunodeficiency virus encephalopathy, human immunodeficiency virus wasting syndrome, and a broader range of opportunistic infections and malignancies. It also allowed presumptive diagnoses of cerebral toxoplasmosis, Pneumocystis carinii pneumonia, cytomegalovirus retinitis, Kaposi's sarcoma, disseminated mycobacterial infection, and esophageal candidiasis.1,2 We report herein our first four months of experience with this new case definition.

Methods.  —All cases of AIDS diagnosed in San Francisco are reported to the San Francisco Department of Public Health.3Previous studies comparing cases of AIDS with death certificates, pathology and laboratory logs, medical records, and requests for pentamidine and ansamycin have shown that 98% of the cases of AIDS that are diagnosed in San Francisco are reported.4To assess the impact of