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HIV and Disability Updating the Social Security Listings (2010) / Chapter Skim
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4 Imminently Fatal or Severely Disabling HIV-Associated Conditions
Pages 53-62

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From page 53...
... This chapter identifies and describes these conditions and discusses how the committee believes they should be addressed in the HIV Infection Listings. IMMINENTLY FATAL OR SEVERELY DISABLING CONDITIONS Although the treatment of HIV infection has improved greatly since the beginning of the epidemic with the development of combination antiretroviral therapy, some rare but very aggressive conditions occur that can rapidly lead to death or severe disability (see Box 4-1)
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From page 54...
... It refers to severe impairment (measured as performance greater than two standard deviations below normal) in at least two cognitive domains that extremely limits everyday functioning (Antinori et al., 2007)
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From page 55...
... However, given its severity in those infected with HIV, the disease should be considered in the HIV Infection Listings. Kaposi's Sarcoma Involving the Pulmonary Parenchyma Kaposi's sarcoma is a fatal condition when it manifests in the lungs, where it tends to grow as sheets of tumor tissue in the peribronchial and perivascular axial interstitial spaces.
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From page 56...
... The committee concludes that due to the aggressive and fatal nature of pulmonary Kaposi's sarcoma, it needs to be retained in the HIV Infection Listings and should be considered a permanent disability. Primary Central Nervous System Lymphomas Primary central nervous system lymphomas are aggressive B-cell, nonHodgkin's lymphomas arising within the central nervous system (CNS)
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From page 57...
... Progressive Multifocal Leukoencephalopathy Progressive multifocal leukoencephalopathy (PML) is a rare disorder caused by polyomavirus JC.
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From page 58...
... It is worth noting that in 2007, SSA launched a program called "compassionate allowances" as a way of quickly identifying conditions that should be deemed permanently disabling and providing these claimants with disability benefits. Compassionate allowance cases require minimal objective medical evidence to determine the claimant disabled and eligible to receive benefits.
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From page 59...
... These include the following: • HIV-associated dementia; • Multicentric Castleman's disease; • Kaposi's sarcoma involving the pulmonary parenchyma; • Primary central nervous system lymphomas; • Primary effusion lymphoma; and • Progressive multifocal leukoencephalopathy. REFERENCES Aboulafia, D
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From page 60...
... 2008. Influence of HAART on the clinical course of HIV-1-infected patients with progressive multifocal leukoencephalopathy: Results of an observational multicenter study.
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From page 61...
... 2007. Persistence of neuropsychological deficits despite long-term highly active antiretroviral therapy in pa tients with HIV-related neurocognitive impairment: Prevalence and risk factors.
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Key Terms

  • hiv infection
  • severely disabling
  • progressive multifocal
  • combination antiretroviral
  • primary effusion

  • multifocal leukoencephalopathy
  • effusion lymphoma
  • imminently fatal
  • highly active
  • infection listings

  • active antiretroviral
  • disabling conditions
  • central nervous
  • primary central
  • immune deficiency

  • permanent disability
  • acquired immune
  • compassionate allowance
  • conditions identified
  • deficiency syndromes

  • pulmonary parenchyma
  • potent antiretroviral
  • compromised immune
  • disabling condition
  • compassionate allowances

  • fatal condition
  • determination process
  • sarcoma involving
  • median survival
  • primary infection


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