Index

Abacavir, 79

Acceptable sources of information, 106107

medical sources, 11, 22

Acquired immunodeficiency syndrome. See AIDS

Activities of daily living

ability to perform, 9, 35

defining, 120

Adherence. See Medication adherence

Administrative law judge (ALJ), 21

Advanced Notice of Proposed Rulemaking (ANPRM), 2324, 148

Age factors, 34

AIDS, 1, 15

cause of discovered, 46

estimated numbers of case reports, 38

AIDS-defining conditions

cancers, 82

presenting with severe diarrhea, 144

Allowances

duration of, 84

by sublisting 14.08, 25

by sublisting 114.08, 25

Antibiotics, 66, 117

Antineoplastic therapy, 71

Antiretroviral therapy, ix, 5556, 63, 79, 88

adherence to, x, 2, 28, 39, 65

advances in, 7071

adverse effects of, 83

attenuated response to, x

development of combination, 53

making HIV infection manageable, 1, 33

monitoring response to, 6

resistance to, 104

Appeals process, ix, 21

Atherosclerosis, 78

Attention deficit hyperactivity disorder, 91

Autoimmune disorders, 110, 125

Azidothymidine (AZT), 36

Beck Depression Inventory, 28

Benefit amounts, and initial allowances, 17

Benton Visual Retention Test, 28

Blindness, 2n, 16n

Body mass index (BMI), 69

Brain atrophy, 94

Brain biopsy, 58

Brain growth, impaired, 94

Breastfeeding, perinatal HIV through, 87

Bronchoscopy, 56

CAL (Compassionate ALlowances), 17n, 58

California Verbal Learning Test, 28

Cancers, 1, 45, 138, 145146.

See also individual cancers

AIDS-defining, 82

a leading cause of HIV morbidity and mortality, 77

non-AIDS-defining, 82, 158

Cardiovascular disease, xi, 7, 39, 7879, 103, 158

a leading cause of HIV morbidity and mortality, 77



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Index Abacavir, 79 monitoring response to, 6 resistance to, 104 Acceptable sources of information, 106–107 Appeals process, ix, 21 medical sources, 11, 22 Atherosclerosis, 78 Acquired immunodeficiency syndrome. See Attention deficit hyperactivity disorder, 91 AIDS Autoimmune disorders, 110, 125 Activities of daily living Azidothymidine (AZT), 36 ability to perform, 9, 35 defining, 120 Beck Depression Inventory, 28 Adherence. See Medication adherence Administrative law judge (ALJ), 21 Benefit amounts, and initial allowances, 17 Advanced Notice of Proposed Rulemaking Benton Visual Retention Test, 28 (ANPRM), 23–24, 148 Blindness, 2n, 16n Age factors, 34 Body mass index (BMI), 69 AIDS, 1, 15 Brain atrophy, 94 cause of discovered, 46 Brain biopsy, 58 estimated numbers of case reports, 38 Brain growth, impaired, 94 AIDS-defining conditions Breastfeeding, perinatal HIV through, 87 cancers, 82 Bronchoscopy, 56 presenting with severe diarrhea, 144 Allowances CAL (Compassionate ALlowances), 17n, 58 duration of, 84 California Verbal Learning Test, 28 by sublisting 14.08, 25 Cancers, 1, 45, 138, 145–146. See also by sublisting 114.08, 25 indiidual cancers Antibiotics, 66, 117 AIDS-defining, 82 Antineoplastic therapy, 71 a leading cause of HIV morbidity and Antiretroviral therapy, ix, 55–56, 63, 79, 88 mortality, 77 adherence to, x, 2, 28, 39, 65 non-AIDS-defining, 82, 158 advances in, 70–71 Cardiovascular disease, xi, 7, 39, 78–79, adverse effects of, 83 103, 158 attenuated response to, x a leading cause of HIV morbidity and development of combination, 53 mortality, 77 making HIV infection manageable, 1, 33 

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4 INDEX Caregivers, 91 methods, 29–30 Categories of recommended HIV disability scope of the report, 30–31 allowances in report, x–xii Comorbidities of HIV, 9, 34–35 HIV-associated conditions without anxiety, 28, 35, 91 Listings in other body systems, xi behavioral disorders, 35 HIV-associated diseases with existing bipolar disorder, 28, 35 Listings elsewhere, xi–xii cognitive dysfunction, 35 imminently fatal conditions, xi cognitive limitations, 34-35, 103 low CD4 count, x–xi delirium, 35 CD4 cell count, 34, 47–49, 113, 129 drug dependence, 35 indicating disease progression, 45–50 in the Listings, 83–84 as an indicator of disability, x–xi, 6–7, major depressive disorder, 34 45–52 posttraumatic stress disorder, 35 progression of untreated HIV infection psychiatric disorders, 35 demonstrated by, 46 schizophrenia, 28, 35 Centers for Disease Control and Prevention substance abuse, 34 (CDC), x, 1, 15, 29, 33, 47, 82, 96, 105 Composite International Diagnostic Central nervous system (CNS), lymphomas Interview, 28 arising within, 56, 82, 148 Concurrent conditions, 63 Cervical cancer, invasive, 82 Conditions covered elsewhere in the Children, defining, 2n Listings, 10, 77–84 Children with HIV/AIDS cardiovascular disease, 10, 78–79, 84 concepts specific to, x, 10–12, 87–99, chronic kidney disease, including HIV- 131–132 associated nephropathy, 10, 79–80, 84 mood disorders, with HIV, 91 diabetes, 10, 80–81, 84 proposed disabling CD4 count ranges hepatitis, 10, 81–82, 84 for children, 11 list of, 10, 78, 84 rationale for listing recommendations for malignancies not otherwise specified, 10, pediatric patients, 92–96 82–84 specialized evaluation of cases involving, Conditions currently without Listings, 9, 21 64–74 survival and prognosis, 88–92 diarrhea, 9, 64–66, 73 Children with HIV Early Antiretroviral distal sensory polyneuropathy, 9, 64, Therapy trial, 90 66–67, 74 Chronic conditions HIV-associated neurocognitive disorders associated with aging, 15 (HAND), 9, 64, 67–69, 74 HIV infection as, ix, 33, 101 HIV-associated wasting syndrome, 9, 64, Chronic diarrhea, defining, 66 69–70, 74, 123 Chronic hepatitis, 81 Kaposi’s sarcoma, 9, 64, 70–71, 74 Chronic inflammatory state, associated with lipoatrophy and lipohypertrophy, 9, 64, HIV infection, 33, 78 71–72, 74 Chronic kidney disease osteoporosis, 9, 64, 72–74 including HIV-associated nephropathy, Contrast-enhanced computed tomography 79–80 (CT), 56, 72 an increasing problem for the HIV- “Controlling weight,” applied to treating infected, xi source opinions, 22 Chronic pancreatitis, 147–148 Cross-referencing procedure in the SSA, 77, Cirrhosis of the liver, 81 83–84 Collagen-vascular diseases, 81 Curcumin, 66 Combined antiretroviral therapy. See Current concepts in HIV/AIDS, 33–43 Antiretroviral therapy evolution of the epidemic, 33–36 Committee on Social Security HIV improvements in functioning and Disability Criteria, 1–2, 29–31 capacity to return to work, 39–41 charge to, 1–2, 16, 141–155 management of HIV/AIDS, 36–39 considerations for developing a Listing, 30

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 INDEX Current HIV/AIDS antiretroviral drugs, importance of functioning in 159–162 determining, 63–65 entry inhibitors, CCR5 coreceptor measures of, 50 antagonist, 162 surrogate markers of, 45 fusion inhibitors, 162 Disability allowances HIV integrase strand transfer inhibitors, defining pathways to, xi 162 permanent, xi multiclass combination products, 159 regular review of, xi, 73–74 nonnucleoside reverse transcriptase Disability benefits inhibitors (NNRTIs), 161 applying for, ix nucleoside reverse transcriptase for people with AIDS, 1–2, 15 inhibitors (NRTIs), 159–160 qualifying for, 2 protease inhibitors (PIs), 161 Disability data Current HIV Infection Listings (14.08 and deidentified, xi, 12, 105 114.08) of Impairments, 109–139 uses of, 105 HIV Infection Listing, 47, 122–124, Disability Determination Services (DDSs), 137–139 21, 106 HIV Infection Listing Introductory Text, Disability evaluation decision process, ix, 110–122, 125–136 16–20, 21 Part A, 20, 109 for adults, 2–3 Part B, 20, 124–125 appeals process, 21 Cytomegalovirus (CMV) disease, problems for children, 3 documenting, 114–115, 130 definition of disability, 16–17 five-step sequential evaluation process, 17–20 D-dimer levels, 34 initial decisions, 21 Data. See Disability data Disability examiners Data Collection on Adverse Events of Anti- expertise of, 24 HIV Drugs Study, 78 reducing turnover in, 108 Death certificates, in which HIV disease was Disease progression, measures predictive underlying cause of death, 38 of, 45 Deidentified data. See Disability data Distal sensory polyneuropathy, 8, 66–67 Dementia, HIV-associated, 11 Drug dependence, with HIV, 35 Department of Health and Human Services “Drug holiday,” 117–118, 134 (HHS), guidelines from, 102 Drug resistance, 65 Depression, 39 Dual X-ray absorptiometry (DEXA), 72 Developing a Listing, considerations for, 30 Developmental disorders, 11, 88, 95 ELISA screening test, 112, 128 Developmental milestones, loss of previously acquired or delay of, 94 Employment, common barriers to, 40 Diabetes, 39, 80–81 Employment capability and HIV, literature Diagnosis, timely, 2 review on, 166–183 Encephalopathy, 148, 151 Diagnostic and Statistical Manual of the Endothelial dysfunction, 78 American Psychiatric Association (DSM-IV-TR), 28 Entry inhibitors, 36 Dialysis, 80 Epstein-Barr virus (EBV), 55, 83 Diarrhea, 65–66, 139, 142–144, 151 Ethnicity factors, 34 frequency of in clinical trials using EuroSIDA, data from, 29, 65 protease inhibitor-based therapy, 144 Evaluation. See Sequential evaluation Didanosine, 79, 147 process Diphenoxylate, 66 Evolution of the epidemic, 33–36 Disability comorbidities of HIV, 34–35 Americans working with, 40 HIV and aging, 35–36 defining, 2, 16–17 pathogenesis of HIV, 34

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 INDEX Fatigue, 9, 66, 111 conditions covered elsewhere in the Listings, 77–83 Federal Register, 23 without Listings elsewhere, xi, 8–9, 63–76 Finger Tapping Test, 28 conditions currently without Listings, Fracture Risk Assessment Tool, 72–73 65–73 French Perinatal Cohort, 90 HIV-associated conditions in the Functional assessment of the patient with Listings, 73–74 HIV/AIDS, ix, 26–29, 117–118, importance of functioning in 133–134 determining disability, 63–65 categories of functional assessment, list of, 64 26–27 HIV-associated diseases, with existing decline in functional abilities after Listings elsewhere, xi–xii diagnosis, 26 HIV-associated neurocognitive disorders importance of, 29 (HAND), 67–69 in the mental domain, 27 HIV-associated asymptomatic in the neurocognitive domain, 27 neurocognitive impairment (HIV in the physical domain, 27 ANI), 69 three scales of self-measurement, 28 HIV-associated dementia (HAD), 54–55, tools to measure, 27–29, 135 68 Functioning HIV-associated mild neurocognitive HIV infection still allowing high levels disorder (HIV MND), 68 of, ix most commonly affected domains of importance in determining disability, cognitive functioning, 68 63–65 HIV-associated wasting syndrome, 9, 64, improvements in, 39–41 69–70, 74, 123, 144, 151 Fusion inhibitors, 36 HIV disease Future revisions, potential areas for, 104 and aging, 35–36 as a disabling condition, ix Griffiths Mental Development Test, 91 documenting and evaluating, 112–113, Growth disturbances, 10–11, 88–89, 94, 129–131 138–139, 151 listed on death certificates as underlying Guidelines for the Management of Chronic cause of death, 38 Kidney Disease in HIV-Infected pathogenesis of, 34 Patients, 79 HIV Infection Listings, ix–x, 1–2, 24–26, 51, 122–124, 137–139. See also Halstead Category Test, 28 Introductory Text Hamilton Depression Inventory, 28 allowances by sublisting 14.08, 25 Health care professionals, allowing to allowances by sublisting 114.08, 25 provide input into the determination bacterial infections, 122, 137 process, xii, 13 current, 109–139 Hepatitis coinfection, 67, 80–82, 146–147 fungal infections, 122, 137 Hepatocellular carcinoma, 81, 83 helminthic infections, 122, 137 Highly active antiretroviral therapy most and least used sublistings of 14.08, (HAART), 36, 133, 141 26 HIV principles for new, 30 described, 1, 15 protozoan infections, 122, 137 HIV/AIDS-related illnesses and urgent need for revising, x, 1 malignancies, 158 viral infections, 122–123, 137–138 AIDS-defining illnesses and malignancies, HIV Pediatric Prognostic Markers 158 Collaborative Study, 93 HIV-associated conditions HIV RNA, 46, 93 in the Listings, 73–74 Hodgkin’s lymphoma, 83 with Listings elsewhere, 9–10, 77–86 HOPS cohort, 144 comorbidity in the Listings, 83–84 Human herpesvirus-8 (HHV-8), 55, 70

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 INDEX Human immunodeficiency virus. See HIV Information Human papillomavirus, 83 “accepted medical source,” 13 Hyperreflexia, 90 credible sources of, x Hypertonicity, 90 from medical records and SSA disability forms, 106 Initial allowances, and benefit amounts, 17 Imminently fatal or severely disabling HIV- Initial decisions, 21 associated conditions, xi, 7, 53–61, Institute of Medicine (IOM), xii, 1, 16, 141 93–94 Insulin resistance, 90 HIV-associated dementia, 7, 54–55, Integrase inhibitors, 36 59 Intellectual ability, loss of previously imminently fatal or severely disabling acquired or delay of, 94 conditions, 53–58 Intelligence tests, 29 impaired brain growth, 94 Interleukin-6 levels, 34 Kaposi’s sarcoma involving the International Classification of Disorders pulmonary parenchyma, 7, 55–56, (ICD-10), 28 59 Introductory Text, 11, 101–103 loss of previously acquired or delay definitions in, 111–112, 126–127 of developmental milestones and general principles in, 102–103 intellectual ability, 94 making user friendly, 103 multicentric Castleman’s disease (MCD), maximizing the utility of the HIV 7, 55, 59 Infection Listings, 101–103 place in the determination process, reflecting changes in the Listings in, 102 58–59 simplifying language in, xi, 102 primary central nervous system technical overview to, 103 lymphomas, 7, 56, 59 primary effusion lymphoma, 7, 57, 59 Kaposi’s sarcoma (KS), 45, 70–71, 82 progressive motor dysfunction, 94 progressive multifocal involving the pulmonary parenchyma, leukoencephalopathy (PML), 7, 55–56 57–59 Immune function Limitations progressive disruption of, 15 “extreme,” 19 recovery of, x “marked,” 19, 119–120 Immune reconstitution inflammatory Lipid profiles, HIV-induced changes in, 78, syndrome (IRIS), 49 89 Immune system, generalized activation and Lipoatrophy and lipohypertrophy, 71–72, 89 inflammation of, 34 Listing of Impairments (the Listings), ix, Immunodeficiency disorders 4–5, 8, 20 excluding HIV infection, 110, 126 based on age-specific CD4 criteria, progressive in HIV, 1 92–93 severe and advanced, 6 functionally equaling, 19 Immunofluorescence assay, 112, 128 guidance on implementing, 12 Immunoglobulin G (IgG) levels, 129 history and purpose, 20 Immunologic reserve, 46 meeting or medically equaling, 5, 18 Impairments. See Listing of Impairments need to cross-index, 103 Indicators of disease progression, 45–50 proposed disabling CD4 count ranges CD4 count, 47–49 for children, 93 HIV-1 viral load, 49–50 setting severity standard of, 20 mortality rates for patients with HIV structure of, 20 infection, 48 Literature review on employment capability progression of untreated HIV infection and HIV, 166–183 demonstrated by CD4 count and disability, 166–167 viral load, 46 employment, 168–177 Indinavir, 79 functional capacity, 178–181

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 INDEX methods, 163–164 Mesalamine, 66 quality of life, 182–183 Methods, 29–30, 163–164. See also search strategy, 164 indiidual tests and measures used severity of impairment, 182–183 preliminary analysis and results, 164 Loperamide, 66 search strategy, 164 Lopinavir-ritonavir, 79 Morbidity, measures predictive of, 45 Lymphocytic interstitial pneumonia/ Mortality pulmonary lymphoid hyperplasia improving patient longevity, 101 (LIP/PLH) complex, 95–96, 139, 151 measures predictive of, 45 Mortality rates, 1 declining, 33 Magnetic resonance imaging (MRI), 56, with and without therapy, 47–48 58, 72 Multicenter AIDS Cohort Study, data from, Malaise, 9, 111 29, 80 Malignancies. See also Cancers Multicentric Castleman’s disease (MCD), 7, not otherwise specified, 82–83 55, 59 Malignant neoplasms. See Cancers Malignant Neoplastic Diseases Listings, 71 Narcotics, for pain management, 67 Malnutrition. See Wasting syndrome; Weight loss “Narrative” of patient, 28 Management of HIV/AIDS, 36–39. See also National Association for Disability Medication adherence Examiners, 105 death certificates in which HIV disease National Institutes of Health, 105 was underlying cause, 38 Nephropathy, HIV-associated, chronic estimated numbers of U.S. AIDS case kidney disease including, 79–80 reports, 38 Neurocognitive domain, of functional replication cycle of HIV with stages to assessment, 27 initiate treatment, 37 Neurocognitive impairment, related to treatment side effects, 38–39 unemployment, 41 Maximizing the utility of the HIV Infection Neurological manifestations of HIV Listings, 12–13, 101–108 infection, 10–11, 90–91, 94, 138, 151 acceptable sources of information, Non-AIDS-defining cancers, 82 106–107 Non-Hodgkin’s lymphoma, 56, 82 information from medical records and Nonadherence. See Medication adherence SSA disability forms, 106 Nonnucleoside reverse transcriptase reevaluating the Listings, 103–105 inhibitors, 36, 83 research on functional assessment and “Nonspecific therapy,” 66 return to work, 108 North American AIDS Cohort Collaboration training of disability examiners and on Research and Design medical consultants, 107–108 (NA ACCORD), data from, 29, 65 use of data, 105 Notice of Proposed Rulemaking (NPRM), Medical reports, obtaining, 22, 110–111 23–24 Medical sources. See also Acceptable Nucleoside analogues, 36 sources of information Nucleoside reverse transcriptase inhibitors, acceptable medical sources, 22–23 79, 81, 88 “other medical sources,” 23 Nutrition for Healthy Living Cohort, 66 Medical-vocational factors, considering, 26 Occupational Performance History Medically determinable impairment (MDI), Interview (OPHI-II), 28 3n, 16n Opportunistic diseases and infections, ix–xi, Medication adherence, x, 2, 28, 39, 65 1, 8, 45, 63–65, 88, 145–146 challenges in, 91–92 Oropharyngeal cancer, 83 Memory tests, 29 Osteoporosis, 72–73 Mental domain, of functional assessment, an increasing problem for the HIV- 27, 121 infected, 8

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 INDEX PACTG 219C cohort, 89 lymphocytic interstitial pneumonia/ pulmonary lymphoid hyperplasia Pain management, 9, 67 complex, 95–96 Part A of the Listings, 20, 109 Reconsideration, requesting, 21 Part B of the Listings, 20, 124–125 Reevaluating the Listings, 103–105 Pathogenesis of HIV, 34 potential areas for future revisions, 104 Pathways to disability allowances, defining, revision process, 104–105 xi Renal disease, end-stage, 79–80 Patient Protection and Affordable Care Act Replication cycle of HIV, with stages to (2010), 2, 30 initiate treatment, 37 Pediatric Spectrum of Disease Cohort, 88 Residual functional capacity (RFC), 19 Perinatal HIV Resistance in growing children and adolescents, transmitted, 104 complications of, 87–89 in treating patients with HIV infection, through breastfeeding, 87 37–38 Peripheral neuropathy, 66–67 Resistance mutations, 88, 104 Pharmacodynamics, individual, 104 Return-to-work patterns, for people with Physical domain, of functional assessment, HIV/AIDS, 40 27–28, 111 Revising the HIV Infection Listing, 5–12, Pneumocystis pneumonia (PCP), 45, 47, 23–24 105 concepts specific to children, 10–12 reclassified, 24 imminently fatal or severely disabling Polyomavirus JC, 56 HIV-associated conditions, 7 Predictors, of response to treatment, x, 63 low CD4 count, 6–7 Primary central nervous system lymphomas, other severe HIV-associated conditions, 56, 82 7–10 Primary effusion lymphoma (PEL), 57, 82 Revision process, 104–105 Profile of mood states, 28 Rifampin, 148 Progression of untreated HIV infection, Rituximab, 55 demonstrated by CD4 count, 46 Ryan White Care Act, 30–31 Progressive motor dysfunction, 94 Progressive multifocal leukoencephalopathy Scope of the report, 30–31 (PML), 57–58 Protease inhibitors (PIs), 36, 79, 81, 143 Self-care activities, ability to perform, 120 Psychotropic medications, for HIV-infected Self-measurement scales, 28 youth, 91 occupational competence, 28 Pubertal delay, 88 occupational identity, 28 Public assistance, 15 occupational setting, 28 Public comments, on revising and updating Sequential evaluation process, five-step, 4, the Listings, 24 17–20 Severe HIV-associated conditions, 7–10 QDD (Quick Disability Determination), HIV-associated conditions with Listings elsewhere, 9–10 17n HIV-associated conditions without Listings elsewhere, 8–9 Rationale for listing recommendations for Side effects of treatment, 38–39 pediatric patients, 92–96 Social functioning, maintenance of, 9, 66, HIV-associated comorbidities currently 120 with Listings, 95 Social Security Administration (SSA), ix–x, HIV-associated comorbidities currently 15, 102, 141 without Listings, 95 cross-referencing procedure within, 77, imminently fatal or severely disabling 83–84 HIV-associated conditions, 93–94 data from, 29 Listings based on age-specific CD4 disability evaluation process, 2–5, 4, 18 criteria, 92–93

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00 INDEX maximizing the utility of the Listings, Training of disability examiners and medical 12–13 consultants, 107–108 number of initial allowances and benefit Transbronchial biopsy, 56 amounts, 17 Transitioning, of youth to adult care responsibilities of field office staff, 21 providers, 92 review by appeals council, 21 Transmission of HIV, mother-to-child, 15 Social Security Disability Insurance (SSDI), Treatment 2, 16, 20 considering effects of, 132 Social stigma, 70 minimal response to, xi Stages to initiate treatment, replication cycle predictors of poor response to, x of HIV with, 37 side effects, 38–39, 103–104 Statement of work, 3, 31 stages to initiate, replication cycle of Stavudine (d4T), 71, 147 HIV with, 37 Steroid treatment, 55 unpredictable nature of, 73, 116–117, Structure, of the Listing of Impairments, 20 132–133 Structured treatment interruption (STI), Trimethoprim/sulfamethoxazole, 46, 148 117–118, 134 Sublisting 14.08 U.S. Military (DoD) HIV Natural History allowances by, 25 Study, data from, 29 comparison of current Listing to suggested revisions, 149–150 Veterans Aging Cohort Study, data from, most and least used, 26 29 Sublisting 114.08 Viral load (VL), 6, 12, 37, 49–50, 128 allowances by, 25 progression of untreated HIV infection comparison of current Listing to demonstrated by, 46 suggested revisions, 152–153 Viral resistance, development of, 39 Substantial gainful activity (SGA), 2n, 16n, Viremia, persistent, 65 20 Supplemental Security Income (SSI), 2, 16 Wasting syndrome, 9, 64, 69–70, 74, 123, Survival and prognosis, 88–92 144, 151 adherence and behavioral challenges, Weight loss. See also Wasting syndrome 91–92 involuntary, 69, 115–116, 139 complications of perinatal HIV in Western blot assay, 112, 128 growing children and adolescents, Wisconsin Card Sorting Test, 28 88–89 Women, HIV infection manifestations growth complications, 89 specific to, 115 metabolic complications, 89–90 Women’s Interagency HIV Study, 81 neurologic complications, 90–91 Work prolonged despite HIV infection, ix–x ability to, 15, 63 Swiss HIV Cohort Study, 72, 81 defining “gainful,” 2n, 16n Symptoms, consideration of, 118, 134–135 defining “substantial,” 2n, 16 improvements in capacity to return to, T-cells. See CD4 cell count 39–41 Tasks, completing in a timely manner, 9, World Health Organization (WHO), 72 120 TERI (TERminal Illness) cases, 17n Zidovudine (ZDV), 36 Therapy, advances in, 15 Zung Depression Inventory, 28 Thymidine nucleoside reverse transcriptase inhibitors, 71