ORDIN
Nr. 1611 din 7 decembrie 2004
privind aprobarea circuitului informational si a fiselor de declarare si
supraveghere a infectiei HIV/SIDA
ACT EMIS DE: MINISTERUL SANATATII
ACT PUBLICAT IN: MONITORUL OFICIAL NR. 31 din 11 ianuarie 2005
Avand in vedere prevederile Legii nr. 100/1998 privind asistenta de
sanatate publica, cu modificarile si completarile ulterioare,
vazand Referatul de aprobare al Directiei generale de sanatate publica si
inspectie sanitara de stat nr. OB14.090/2003,
in temeiul prevederilor Hotararii Guvernului nr. 743/2003 privind
organizarea si functionarea Ministerului Sanatatii, cu modificarile si
completarile ulterioare,
ministrul sanatatii emite urmatorul ordin:
Art. 1
Se aproba Circuitul informational in supravegherea infectiei HIV/SIDA,
prevazut in anexa nr. 1.
Art. 2
Se aproba Fisa de declarare a suspiciunii de infectie HIV/SIDA, prevazuta
in anexa nr. 2.
Art. 3
Se aproba Fisa de supraveghere pentru infectia HIV/SIDA, prevazuta in anexa
nr. 3.
Art. 4
Anexele nr. 1 - 3 fac parte integranta din prezentul ordin.
Art. 5
La data intrarii in vigoare a prezentului ordin toate prevederile legale
contrare se abroga.
Art. 6
Directia generala de sanatate publica si inspectie sanitara de stat,
Institutul de Boli Infectioase "Prof. dr. Matei Bals", directiile de
sanatate publica judetene si, respectiv, a municipiului Bucuresti, centrele
regionale HIV/SIDA, toate laboratoarele de analize medicale, indiferent de
forma de organizare, vor duce la indeplinire prevederile prezentului ordin.
Art. 7
Prezentul ordin va fi publicat in Monitorul Oficial al Romaniei, Partea I.
Ministrul sanatatii,
Ovidiu Brinzan
ANEXA 1
CIRCUITUL INFORMATIONAL
in supravegherea infectiei HIV/SIDA
Sursele de informatie in supravegherea infectiei HIV/SIDA sunt:
- laboratoarele directiilor de sanatate publica;
- laboratoarele spitalelor/sectiilor de boli infectioase;
- laboratoarele private;
- centrele de transfuzii;
- laboratoare ale altor unitati sanitare.
NOTA:
Conform reglementarilor legale in vigoare, toate laboratoarele care
efectueaza teste HIV trebuie sa fie acreditate si sa asigure consiliere pre si
posttestare.
Transmiterea datelor de la sursele de informatie:
- la primul test reactiv, laboratorul completeaza fisa de declarare a
suspiciunii (anexata) si o trimite la directia de sanatate publica locala in
termen de 24 de ore;
- laboratorul indruma persoana testata cu o proba reactiva catre directia
de sanatate publica locala (medic epidemiolog desemnat) sau la spitalul/sectia
de boli infectioase (medic infectionist desemnat).
Confirmarea cazului:
1. In situatia in care persoana testata ajunge direct la directia de
sanatate publica (DSP), aceasta confirma cazul de infectie HIV conform
definitiei de caz, face consiliere posttestare si trimite pacientul la spitalul
de boli infectioase pentru incadrare clinica.
2. In situatia in care persoana testata ajunge direct la spitalul de boli
infectioase, acesta confirma cazul de infectie HIV conform definitiei de caz,
face consiliere posttestare, face incadrarea clinica si completeaza fisa de
supraveghere a infectiei HIV.
Daca spitalul nu poate efectua testele ELISA, confirmarea se face prin DSP.
Fisa de supraveghere:
- se completeaza de catre medicul infectionist, care o semneaza, o parafeaza
si o transmite la directia de sanatate publica locala in termen de 24 - 48 de
ore de la confirmare si/sau in maximum 3 luni de la depistarea cazului;
- medicul epidemiolog care primeste fisa - responsabilul de program HIV -
are obligatia sa verifice daca fisa este completata in conformitate cu
instructiunile; o semneaza, o parafeaza si o transmite la directia de sanatate
publica regionala, denumita DSP regionala.
DSP regionale sunt directiile de sanatate publica din judetele unde
functioneaza centre regionale HIV/SIDA.
DSP regionale au urmatoarele atributii:
- primesc fise de supraveghere HIV de la directiile de sanatate publica din
judetele arondate centrului respectiv;
- trimit fisele primite la Ministerul Sanatatii - Directia generala de
sanatate publica si inspectia sanitara de stat si la centrul regional in
maximum o luna.
DSP locale sunt directiile de sanatate publica din acelasi judet cu
laboratorul privat, spitalul/sectia de boli infectioase etc.
In situatia in care centrul regional primeste direct fise de supraveghere a
infectiei HIV de la spitalele de boli infectioase din judetele arondate, acesta
are obligatia de a le trimite la DSP regionala. DSP regionala va informa DSP
locala despre cazul respectiv. DSP locala va contacta spitalul de boli
infectioase pentru intrarea fisei in circuitul informational corect. DSP
regionala va pastra fisele respective pana la reintrarea in circuit.
In situatia in care centrul regional depisteaza un caz nou, fisa de
supraveghere va fi trimisa la DSP regionala, care o trimite la DSP locala si la
Ministerul Sanatatii - Directia generala de sanatate publica si inspectie
sanitara de stat.
Spitalele de boli infectioase, indiferent daca sunt sau nu centre
regionale, daca au depistat un pacient cu domiciliul in alt judet, vor trimite
fisa de supraveghere a acestuia la DSP locala. Toate directiile de sanatate
publica judetene si a municipiului Bucuresti au obligatia sa transmita fisa de
supraveghere a infectiei HIV/SIDA la directia de domiciliu al pacientului, de
unde fisa va intra in circuitul descris anterior.
DSP regionale si centrele regionale vor confrunta bazele de date HIV/SIDA o
data la 3 luni.
Centrele regionale trimit lunar fisele de supraveghere HIV/SIDA la CNLAS.
Ministerul Sanatatii si CNLAS vor confrunta bazele de date HIV/SIDA
semestrial.
Ministerul Sanatatii impreuna cu CNLAS vor face raportarea catre forurile
internationale.
Actualizarea datelor se face in urmatoarele situatii:
- schimbarea incadrarii clinico-imunologice din HIV in SIDA;
- in caz de deces;
- in caz de pierdere din evidenta;
- in caz de schimbare de domiciliu.
Actualizarea datelor se face de catre spitalul de boli infectioase, fisele
fiind transmise la DSP locala semestrial, de unde intra in circuitul stabilit
pentru fisa de supraveghere.
Schema circuitului informational*)
*) Schema circuitului informational este reprodusa in facsimil.
24 h 24 h max 3 luni lunar lunar
Lab ------> DSP ------> BI ----------> DSP local -----> DSP reg
-----> MS
Caz conf. ^ \\ /\ | ^ | ^
si clasificat | \\ // | | | |
| | \\ //lunar | | 6 luni | |
| | V // V | V |
|____________| DSP domiciliu C. Reg ----->
CNLAS
6 luni lunar
actualizare
ANEXA 2 *1)
*1) Anexa nr. 2 este reprodusa in facsimil.
FISA DE DECLARARE A SUSPICIUNII DE INFECTIE HIV/SIDA
______________________________________________________________________________
| Unitatea medicala | Judet | Data testarii | _ | Data declararii
|
| care a efectuat | | pozitive | Test rapid |_| | la DSP*
|
| testul | | | _ |
|
| | | __/__/____ | ELISA |_| | __/__/____
|
|___________________|_______|_______________|________________|_________________|
NUME .......................... PRENUME ..................................
_ _ _ _ _ _ _ _ _ _ _ _ _
Data nasterii __/__/____ CNP |_|_|_|_|_|_|_|_|_|_|_|_|_|
_ _
Sex: M |_| F |_| Domiciliul declarat ....................................
_ _
Testare la cerere: DA |_| NU |_|
Daca NU medicul/unitatea care a solicitat testarea ........................
Indrumat la: DSP/Boli infectioase (incercuiti varianta aleasa)
MEDIC (semnatura si parafa) ....................
------------
* FISA VA FI TRIMISA IN 24 ORE DE LA CONSEMNAREA REZULTATULUI POZITIV
________________________________________________________________________________
FISA DE DECLARARE A SUSPICIUNII DE INFECTIE HIV/SIDA
______________________________________________________________________________
| Unitatea medicala | Judet | Data testarii | _ | Data declararii
|
| care a efectuat | | pozitive | Test rapid |_| | la DSP*
|
| testul | | | _ |
|
| | | __/__/____ | ELISA |_| | __/__/____
|
|___________________|_______|_______________|________________|_________________|
NUME .......................... PRENUME ..................................
_ _ _ _ _ _ _ _ _ _ _ _ _
Data nasterii __/__/____ CNP |_|_|_|_|_|_|_|_|_|_|_|_|_|
_ _
Sex: M |_| F |_| Domiciliul declarat ....................................
_ _
Testare la cerere: DA |_| NU |_|
Daca NU medicul/unitatea care a solicitat testarea ........................
Indrumat la: DSP/Boli infectioase (incercuiti varianta aleasa)
MEDIC (semnatura si parafa) ....................
------------
* FISA VA FI TRIMISA IN 24 ORE DE LA CONSEMNAREA REZULTATULUI POZITIV
ANEXA 3*)
*) Anexa nr. 3 este reprodusa in facsimil.
FISA DE SUPRAVEGHERE PENTRU INFECTIA HIV/SIDA
_ _
Caz nou |_| Actualizare |_|
________________________________________________________________________________
Unitatea care declara Judet Data completarii Semnatura/parafa medic
cazul ............... __/__/____ Boli infectioase
Unitatea care a emis Judet Data raportarii la DSP Semnatura/parafa medic
suspiciunea ......... __/__/____ epidemiolog
________________________________________________________________________________
Nume ............... Prenume .................. D.N. __/__/__ CNP _____________
_ _
SEX M |_| F |_|
Loc nastere ............ Cetatenie: Etnie: Profesie
_ _ _ _
Scolarizare (nr. clase): 0 |_| < 10 |_| 10 - 12 |_| studii sup. |_|
_ _ _ _
Stare civila: casatorit |_| necasatorit |_| parteneriat |_| vaduv |_|
_
divortat |_|
________________________________________________________________________________
_ _ __________________________
Domiciliu: stabil: /JUDET Mediu: U |_| R |_| | DATE DESPRE MAMA
|
_ _ | (pt. caz sub 13 ani)
|
flotant: /JUDET Mediu: U |_| R |_| | Nume Prenume
|
| Cetatenie Etnie
|
___________________________________________ | Scolarizare (nr. clase):
|
| _ _ | | _ _
|
| Gravida la momentul diagn.: da |_| nu |_| | | 0 |_| < 10
|_| |
| luna sarcinii ............. | | _ _
|
| | | 10 - 12 |_| sup |_|
|
|___________________________________________|
|__________________________|
________________________________________________________________________________
STATUS CURENT
______________________________________________________________________________
|In viata| _ | _
|
| _ | Decedat |_| | Pierdut din evidenta
|_||
| |_| | Data deces __/__/__ Locul decesului ..... | Data __/__/__
|
| | _ _ _ | Data ultimului control
|
| | Deces asociat cu SIDA: DA |_| Nu |_| ? |_|| __/__/__
|
|________|___________________________________________|_________________________|
____________________________________________ _______________________________
| DATE DESPRE DEPISTARE | | DIAGNOSTIC DE LABORATOR
|
| Data primei testari poz __/__/__ | | Data Metoda Rezultat
|
| Data confirmarii __/__/__ | | _____________________________
|
| Data primei raportari __/__/__ | | _____________________________
|
| Data ultimei testari neg __/__/__ | | _____________________________
|
|____________________________________________| | _____________________________
|
| _ _ | | _____________________________
|
| Motivul testarii: expus |_| simptomatic |_|| | _____________________________
|
| _ _ _ | | _____________________________
|
| screening |_| la cerere |_| altul |_| | | _____________________________
|
|____________________________________________|
|_______________________________|
______________________________________________________________________________
| DATE DESPRE NASTERE | CLASIFICARE | Limfocite
|
| (pt. caz sub 13 ani) | CLINICO-IMUNOLOGICA | %
|
| _ _ | _ |
|
| Nascut: domiciliu |_| maternitate |_|| |_| Asimptomatic (gr. N) | Limfocite
|
| specificati maternitatea ........... | ........................ | nr.
|
| Luna gestatie ... A cata sarcina ... | _ |
|
| _ _ | |_| Simptomatologie minora| CD4 %
|
| Gemelara: da |_| nu |_| | (gr. A) specificat .......|
|
| _ | _ | CD4 nr.
|
| Nastere: pe cale naturala |_| | |_| Simptomatologie |
|
| _ _ | moderata (gr. B) |
|
| cezariana |_| forceps |_| | specificat .............. |
|
| _ _ | _ |
|
| pelviana |_| travaliu prelungit |_| | |_| Simptomatologie severa|
|
| _ _ | SIDA (gr. C) | |
| Resuscitat: da |_| nu |_| | specificat .............. |
|
| _ | |
|
| Alimentat la san: da |_| timp | |
|
| _ _ | |
|
| de ... luni nu |_| nu se stie |_| | |
|
|______________________________________|___________________________|___________|
______________________________________________________________________________
| FACTORI DE RISC TMF | FACTORI DE RISC SEXUALI | ALTI FACTORI DE RISC
|
| (pt. caz sub 13 ani) | ________________________ |
__________________________|
| || |Da|Nu| ?|||
|da|nu|?||
| Mama confirmata:
||_______________|__|__|__|||_________________|__|__|_||
| _ _ _ ||Activitate | | | |||Sange si | | |
||
| da |_| nu |_| ? |_| ||sexuala | | | |||derivate | | |
||
| _
||_______________|__|__|__|||_________________|__|__|_||
| Daca nu/?: |_| testata|| Heterosexual | | | ||| An si loc |
||
| _ _ ||_______________|__|__|__|||_________________|_______||
| da |_| nu |_| || Bisexual | | | |||Hemofilie | | |
||
|
||_______________|__|__|__|||_________________|__|__|_||
| Data __/__/__ || Homosexual | | | |||Dializat | | |
||
| Rezultat ............
||_______________|__|__|__|||_________________|__|__|_||
| ||Contact sexual | | | |||Droguri I.V. | | |
||
| Momentul testarii: ||cu partener: | | |
|||_________________|__|__|_||
| _ ||_______________|__|__|__|||Tratam. | | |
||
| Inainte sarcina |_| || Hiv pozitiv | | | |||parenter. | | |
||
| _ ||_______________|__|__|__|||multiple | | |
||
| In timpul sarcinii |_||| SIDA | | |
|||_________________|__|__|_||
| _ ||_______________|__|__|__|||Interv. chir./ | | |
||
| La nastere |_| || Bisexual | | | |||alte manevre | | |
||
| _ ||_______________|__|__|__|||invazive | | |
||
| Dupa nastere |_| || Utilizator | | |
|||_________________|__|__|_||
| || droguri IV | | | |||Insitutionalizat | | |
||
| Status mama: ||_______________|__|__|__|||_________________|__|__|_||
| _ || Ocazionali | | | ||| Prima institutie| | |
||
| in viata |_|
||_______________|__|__|__|||_________________|__|__|_||
| _ || Multipli | | | |||Spitaliz.- | | |
||
| decedata |_| ||_______________|__|__|__|||multiple/prelung.| | |
||
| _ || Prostituate | | |
|||_________________|__|__|_||
| nu se stie |_| ||_______________|__|__|__|||Trat. | | |
||
| || Clienti | | | |||stomatologice | | |
||
| || (prostitutie | | |
|||_________________|__|__|_||
| || masc.) | | | || Expus accidental:
|
| ||_______________|__|__|__|| sange __/__/__
|
| || In detentie | | | || lich. biol. __/__/__
|
| ||_______________|__|__|__|| _ _
|
| || Din alte tari| | | || percutan |_| mucoase |_|
|
| || (precizati) | | | || Profilaxie ARV
|
| ||_______________|__|__|__|| _ _
|
| ||Abuzat sexual | | | || Da |_| Nu |_|
|
| ||_______________|__|__|__||
|_______________________|__________________________|___________________________|
PROFILAXIE TMF SEROLOGIE ____________________________
____________________________ __________________ | STATUS SOCIAL
|
| |da|nu| ?|refuz|| |poz|neg| ?|| __________________________
|
|_____________|__|__|__|_____||_______|___|___|__||| |da|nu|
?||
| Inainte de | | | | ||AgHBs | | |
|||_________________|__|__|__||
| sarcina | | | | ||_______|___|___|__||| In familia | | |
||
|_____________|__|__|__|_____||AntiVHC| | | ||| biologica | | |
||
| In timpul | | | |
||_______|___|___|__|||_________________|__|__|__||
| sarcinii | | | | ||VDRL | | | ||| Adoptat | | |
||
|_____________|__|__|__|_____||_______|___|___|__|||_________________|__|__|__||
| Daca DA: | | || Centru plasament| | |
||
| saptamana | |
||_________________|__|__|__||
|_____________|______________| || Spital | | |
||
| In timpul | | | | | ||_________________|__|__|__||
| travaliului | | | | | || Casa familiala | | |
||
|_____________|__|__|__|_____|
||_________________|__|__|__||
| Dupa nastere| | | | | || Plasament | | |
||
| (COPIL) | | | | | || familial | | |
||
|_____________|__|__|__|_____|
||_________________|__|__|__||
|| Vagabondaj | | |
||
||_________________|__|__|__||
|____________________________|
______________________________________________________________________________
| _ _ _
|
| DATE DESPRE FAMILIE: Sot/sotie ....................... Poz |_| neg |_| ? |_|
|
| _ _ _
|
| Alta persoana ........................................ poz |_| neg |_| ? |_|
|
| _ _ _
|
| Copii: nume .............................. DN __/__/__ Poz |_| neg |_| ? |_|
|
| _ _ _
|
| nume .............................. DN __/__/__ poz |_| neg |_| ? |_|
|
|______________________________________________________________________________|
| COMENTARII _________________________________________________________________
|
| ____________________________________________________________________________
|
|______________________________________________________________________________|
______________________________________________
pag. 2 - caz sub 13 ani | 1| 2| 3| 4| 5| 6| 7| 8|
9|10|decedat|
_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Data consultului | | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Varsta la data consultului | | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Tratament antiretroviral | | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Raportat DSP | | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
Dg.
|
Antecedente deces
|
Data CL A.P
|
______________________________________________________________________________|
| Asimptomatic | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Infectie HIV ac | | | | | | | | | | | |
|
| (Sdr. Retroviral ac.) | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Limfadenopatie | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Hepatomegalie | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Splenomegalie | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Dermatita | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Parotidita HIV | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Infectii resp. rec/persist., | | | | | | | | | | | |
|
| otita | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Alte | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Anemie (< 8 g/dl) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Neutropenie (< 1000/mmc) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Trombocitopenie (< 100.000) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Meningita, pn, sepsis epis. | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Pneumonie bact. Rec fara conf | | | | | | | | | | | |
|
| bact | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Candidoza orofaringiana | | | | | | | | | | | |
|
| (> 2 luni) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Cardiomiopatie | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Infectie CMV (varsta < 1 luna)| | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Diaree cr/rec | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Hepatita HIV | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Stomatita, br, pn, esof. HSV | | | | | | | | | | | |
|
| (v < 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Herpes zoster | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Nefropatie HIV | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Nocardioza | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Febra persistenta > 1 luna | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Toxoplasmoza (v < 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Varicela diseminata/ | | | | | | | | | | | |
|
| complicata | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Hipotrofie staturo-ponderala | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Mycob. tub. pulm. | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Pn. limfoida interstitiala | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Alte | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Inf. bact. mult/rec (2 ani) | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Candidoza pulmonara, br., tr | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Candidoza esofagiana | | | | | | | | | | | | |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Coccidioidomicoza diseminata | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Cryptococoza extrapulm. | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Criptosp./Isosp. cu | | | | | | | | | | | |
|
| diaree > 1 luna | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Boala CMV (v > 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Retinita CMV (v > 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Encefalopatie HIV | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Ulcer, br, pn, esof cu HSV | | | | | | | | | | | |
|
| (v > 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Histoplasmoza diseminata | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Leucoencefalopatie multif. | | | | | | | | | | | |
|
| prog. | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Limfom Pr. cerebral | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Limfom Burkitt, im-bl, alte | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Sepsis cu Salmonella (rec) | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Mycob. tuber. dis/extrap. | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Mycob avium, kansasii | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Mycob dis (alte specii) | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Pn. Cu Pneumocistis Carinii | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Toxo. cerebrala (v > 1 luna) | | | | | | | | | | |
| |
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Sarcom Kaposi | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Emaciere HIV (Wasting sdr.) | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Alte | | | | | | | | | | | |
|
|_______________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| Limfocite | Val. abs. | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | % | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Limfocite CD4+ | Val. abs. | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | % | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Metoda | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| Nr. copii ARN | | | | | | | | | | |
|
|_______________________________|___________|__|__|__|__|__|__|__|__|__|_______|
pag. 3 - caz >/= 13 ani 1 2 3 4 5 6 7 8 9
10|decedat|
______________________________________________________________________|_______|
| | Data consultului | | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Varsta la data consultului | | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Tratament antiretroviral | | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Raportat DSP | | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
|Dg.
|
Antecedente |deces
|
Data |CL A.P
|
______________________________________________________________________|_______|
| 1| Asimptomatic | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 2| Infectie HIV ac | | | | | | | | | | | |
|
| | (Sdr. Retroviral ac.) | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 3| Limfadenopatie | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 4| Alte | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 5| Angiomatoza bacilara | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 6| Manifestari cutanate | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 7| Candidoza orofaringiana | | | | | | | | | | | |
|
| | persistenta | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 8| Candidoza vulvo-vag. | | | | | | | | | | | |
|
| | persist | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| 9| Displazie/carcinom | | | | | | | | | | | |
|
| | cervical situ | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|10| Febra > 1 luna | | | | | | | | | | |
| |
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|11| Diaree > 1 luna | | | | | | | | | | |
| |
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|12| Leucoplakie paroasa | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|13| Herpes zoster | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|14| Purpura trombocit. Idiop. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|15| Listerioza | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|16| Pneumonie bact. episodica | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|17| Boli inflamatorii pelvine | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|18| Neuropatie periferica, | | | | | | | | | | | |
|
| | manif. musc, art. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|19| Alte | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|20| Candidoza pulmonara, | | | | | | | | | | | |
|
| | br., tr | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|21| Candidoza esofagiana | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|22| Cancer cervical invaziv | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|23| Coccidioidomicoza | | | | | | | | | | | |
|
| | diseminata | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|24| Cryptococoza extrapulm. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|25| Criptosp./Isosp. | | | | | | | | | | | |
|
| | (diaree > 1 luna) | | | | | | | | | | |
| |
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|26| Boala CMV (exceptie ficat, | | | | | | | | | | | |
|
| | spl., gg.) | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|27| Retinita CMV (cu orbire) | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|28| Encefalopatie HIV | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|29| Herpes S. ulcer cr., br., | | | | | | | | | | | |
|
| | pn, esof. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|30| Histoplasmoza dis./extrap. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|31| Limfom Burkitt im-bl, | | | | | | | | | | | |
|
| | cerebral | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|32| Leucoencefalopatie | | | | | | | | | | | |
|
| | multifoc. progr. | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|33| Emaciere HIV | | | | | | | | | | | |
|
| | (Wasting syndr.) | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|34| Mycob avium, kansasii | | | | | | | | | | | |
|
| | (dis/extra p.) | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|35| Mycob. tuberculosis | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|36| Pn. cu Pneumocystis | | | | | | | | | | | |
|
| | carinii | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|37| Pneum. bact. rec (1 an) | | | | | | | | | | | | |
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|38| Sarcom Kaposi | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|39| Toxoplasmoza cerebrala | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|40| Sepsis rec. cu Salmonella | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
|41| Alte | | | | | | | | | | | |
|
|__|____________________________|____|______|__|__|__|__|__|__|__|__|__|_______|
| | Limfocite | Val. abs. | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | | % | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Limfocite CD4+ | Val. abs. | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | | % | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | | Metoda | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|
| | Nr. copii ARN | | | | | | | | | | |
|
|__|____________________________|___________|__|__|__|__|__|__|__|__|__|_______|