CDC surveillance case definition laboratory criteria for HIV-1 infection

Persons ≥18 months and children <18 months born to HIV-negative mothers

HIV-infected (1 of the following)

Multitest algorithm consisting of:

Positive HIV antibody or combination antigen/antibody test
Accompanying or subsequent positive result from a supplemental test different from the initial test

Positive result from a multitest HIV antibody algorithm from which only the final result was reported

Positive result or report of a detectable quantity from any of the following HIV virologic tests:

Children <18 months born to mothers with HIV infection or unknown HIV status

HIV-infected (all 3 of the following)

Positive results on at least 1 specimen (not including cord blood) from any of the following HIV virologic tests:

HIV-1 NAT (DNA or RNA)
HIV-1 p24 antigen test, including neutralization assay for a child aged >1 month
HIV isolation (viral culture)
HIV nucleotide sequence (genotype)

Test date is known

1 or both of the following:

Confirmation of the first positive result by another positive result on one of the above virologic tests from a specimen obtained on a different date, or
No subsequent negative result on an HIV antibody test and no subsequent negative result on an HIV NAT before age 18 months

Definitively HIV-uninfected (both of the following)

No positive HIV NAT (RNA or DNA)

At least 1 of the following:

At least 2 negative HIV NATs from specimens on different dates at age ≥1 month of age, 1 of which was obtained at age ≥4 months
At least 2 negative HIV antibody tests from specimens obtained on different dates at age ≥6 months

Presumptively HIV-uninfected (all 3 of the following)

Does not meet criteria for definitively uninfected

Meets at least 1 of the following 4 laboratory criteria:

At least 2 negative NATs from specimens obtained on different dates at age ≥2 weeks, 1 of which was obtained at age ≥4 weeks
1 negative NAT (RNA or DNA) at age ≥8 weeks
1 negative HIV antibody test at age ≥6 months
If criteria for HIV infection had initially been met by 1 positive HIV NAT test, then it must have been followed by at least 2 negative results from specimens obtained on different dates, 1 of which is:
- NAT test from a specimen obtained at age ≥8 weeks, or
- HIV antibody test from a specimen obtained at age ≥6 months

No subsequent NAT

Indeterminate

Does not meet criteria for HIV-infected or HIV-uninfected (definitive or presumptive)

CDC: Centers for Disease Control and Prevention; NAT: nucleic acid test.

Selik RM, Mokotoff ED, Branson B, et al. Revised Surveillance Case Definition for HIV Infection - United States, 2014. MMWR Recomm Rep 2014; 63:1.

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