HIV and Disability Updating the Social Security Listings (2010) / Chapter Skim
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Appendix B: Committee Charge
Appendix B: Committee Charge
Pages 141-156
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From page 141... ...
As part of the reiew, the Consensus Committee shall perform the following subtasks: Subtask A: The Consensus Committee shall surey published scientific literature, research, and studies to gather aailable information on the current medical and functional status (both mental and physical) of the cohort of ery young children who ()
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From page 142... ...
Subtask B: The Consensus Committee shall surey published scientific literature, research, and studies to determine the following: • What published information (for example, medical and ocational literature) is aailable regarding the presence of chronic diarrhea in HIV-infected patients as an indicator of seerity (both prognosti cally and functionally)
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From page 143... ...
Other late-stage conditions may cause severe diarrhea, including microsporidiosis, dis TABLE B-1 Review of 46 Studies of Diarrhea Complicating HIV Infection Characteristic Number of Studies Comment Duration 33 (72%) Ranged from 1–6 weeks 21/33 ≥ 4 weeks 15/29 (52%)
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From page 144... ...
Pre-HAART HAART Condition 1994–1997 2003–2007 Cryptosporidiosis 7.3 0.8 26.9 2.5 Mycobacterium aium Cytomegalovirus 33.0 1.8 NOTE: HAART = highly active antiretroviral therapy. SOURCE: Buchacz et al., 2010.
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From page 145... ...
. Subtask C: The Consensus Committee shall surey published scientific literature, research, and studies related to the opportunistic infections, cancers, or other conditions described in the criteria of immune system disorders listing 4.0 for adults with HIV infection to determine the following: • How has the treatment of these related conditions changed recently?
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From page 146... ...
The lack of indicators contributed to the development of the committee's recommendations. Subtask D: The Consensus Committee shall surey published scientific literature, research, and studies related to the opportunistic infections, cancers, or other conditions described in the criteria of immune system disorders listing 4.0 for children with HIV infection to determine the following: • How has the treatment of these related conditions changed recently?
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From page 147... ...
This finding led to the committee's inclusion of hepatitis in Recommendation 5. Subtask F: The Consensus Committee shall surey published scientific literature, research, and studies related to the coinfection of HIV infection and chronic pancreatitis to determine the following: • Are there indicators that such a coinfection would preent the ability to do any work for a continuous period of at least months?
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From page 148... ...
3. The Consensus Committee shall produce a written report for the use of SSA that compares and contrasts findings in the most current medical literature and ANPRM public comments with SSA's current HIV listings, as well as the key concepts included in the introduction of the HIV listings.
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From page 149... ...
TABLE B-4 Comparison of Current 14.08 Listing to Suggested Revisions Current Listing Suggested Revision Explanation 14.08A Bacterial infections Remove from Listing Bacterial infections themselves are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 14.08B Fungal infections Remove from Listing Fungal infections themselves are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 14.08C Protozoan or helminthic Remove from Listing Protozoan or helminthic infections themselves are no longer predictive of disability; infections claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 14.08D Viral infections Remove from Listing Viral infections are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 14.08E Malignant neoplasms Cross-reference to The current Malignant Neoplasms Listing is adequate to adjudicate claims of HIV Malignant Neoplasms associated malignancies (13.00) 14.08F Conditions of the skin Remove from Listing These conditions are no longer predictive of disability; claimants experiencing or mucous membranes disability would qualify under low CD4 count or other categories of HIV-associated with extensive fungating conditions or ulcerating lesions not responding to treatment 14.08G HIV encephalopathy Revise to reflect "HIV-associated neurocognitive disorders" is the current term used current terminology 4 continued
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From page 150... ...
TABLE B-4 Continued 0 14.08H HIV wasting syndrome Retain as HIV- HIV-associated wasting syndrome can still be disabling if it impairs functioning associated comorbidity currently without listings elsewhere 14.08I Diarrhea Retain as HIV- Diarrhea can still be disabling if it impairs functioning associated comorbidity currently without listings elsewhere 14.08J Other infections Remove from Listing These conditions are no longer predictive of disability; claimants experiencing resistant to treatment or disability would qualify under low CD4 count or other categories of HIV-associated require hospitalization conditions or intravenous treatment 14.08K Other manifestations of Remove from Listing These conditions are no longer predictive of disability; claimants experiencing HIV infection disability would qualify under low CD4 count or other categories of HIV-associated conditions
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From page 151... ...
continues to be a cause of severe disability in children. The committee suggests that both neurological manifestations and growth disturbance be retained as imminently fatal or severely disabling conditions.
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From page 152... ...
TABLE B-5 Comparison of Current 114.08 Listing to Suggested Revisions Current Listing Suggested Revision Explanation 114.08A Bacterial infections Remove from Listing Bacterial infections themselves are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 114.08B Fungal infections Remove from Listing Fungal infections themselves are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 114.08C Protozoan or helminthic Remove from Listing Protozoan or helminthic infections themselves are no longer predictive of infections disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 114.08D Viral infections Remove from Listing Viral infections themselves are no longer predictive of disability; claimants experiencing disability would qualify under low CD4 count or other categories of HIV-associated conditions 114.08E Malignant neoplasms Cross-reference to The current Malignant Neoplasms Listing is adequate to adjudicate claims of Malignant Neoplasms HIV-associated malignancies (113.00) 114.08F Conditions of the skin Remove from Listing These conditions are no longer predictive of disability; claimants experiencing or mucous membranes disability would qualify under low CD4 count or other categories of HIV with extensive fungating associated conditions or ulcerating lesions not responding to treatment 114.08G Neurological Retain as severely Neurological manifestations of HIV infection continue to be disabling manifestations of HIV disabling condition infection 114.08H Growth disturbance Retain as severely Growth disturbances continue to be disabling disabling condition
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From page 153... ...
114.08I Diarrhea Retain as HIV- Diarrhea can still be disabling if it impairs functioning associated comorbidity currently without listings elsewhere 114.08J Lymphoid interstitial Remove from Listing LIP/PLH complex has been shown to be not disabling pneumonia/pulmonary lymphoid hyperplasia complex (LIP/PLH) 114.08K Other infections Remove from Listing These conditions are no longer predictive of disability; claimants experiencing resistant to treatment or disability would qualify under low CD4 count or other categories of HIV require hospitalization associated conditions or intravenous treatment 114.08L Other manifestations of Remove from Listing These conditions are no longer predictive of disability; claimants experiencing HIV infection disability would qualify under low CD4 count or other categories of HIV associated conditions
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From page 154... ...
5. The Consensus Committee shall produce a written report for the use of SSA indicating what eidence, laboratory findings, and signs and symptoms within the medical eidence of record may improe the sensitiity and specificity of the listing criteria to identify indiiduals who meet SSA's definition of disability.
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From page 155... ...
2006. HIV/AIDS: Nutri tion and HIV infection: Review of weight loss and wasting in the era of highly active antiretroviral therapy from the Nutrition for Healthy Living Cohort.
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