WALTER REED STAGING CLASSIFICATION
As more knowledge about HIV infection became known, it became apparent that
a classification system for the progression of HIV/AIDS was necessary. So far, four
classification systems regarding the progression of the HIV infection have been
developed. One of those classification systems was developed by the Army at Walter
Reed Army Medical Center. This system is called the Walter Reed staging
classification for HIV infection. This system is based on current concepts of the
immunopathogenesis of AIDS and attempts to provide an objective scale of the
progression of the disease (HIV infection to AIDS). The Walter Reed stages are defined
according to virologic/serologic evidence of HIV infection, CD4 +T-helper lymphocyte
subset depletion, loss of cutaneous delayed hypersensitivity, and appearance of
opportunistic infections. One of the strengths of this system is that it provides a useful
tool for studying the natural history of "early" HIV infection. This system provides
uniformity of clinical evaluation of patients with documentation of HIV infection. Here
are the stages of the system:
a. WRO. High risk contacts (sexual contacts or blood recipients of HIV-infected
b. WR1--WR6. Require documentation of HIV infection by positive Western Blot
c. WR5. Patient has complete energy or thrush.
d. WR6. Patient has had an opportunistic infection.
3-10. PROBLEMS UNIQUE TO THE MILITARY
The disease AIDS has a special impact on military personnel. Consider the
a. Deployment. American security depends on a fighting force that is 100
percent physically fit and ready to be deployed whenever and wherever needed.
Personnel ill with AIDS will not be able to perform their mission and will also overextend
medical support on noncombat-related problems. Suppose a member of a deployed
unit is diagnosed as having AIDS. Will other unit members want to be near him?
Perhaps not. The result may be undermining individual morale and destruction of unit
espirit de corps.
b. Battlefield Injuries Transfusions. Military personnel may need
transfusions, but the soldiers may be fearful of receiving a blood transfusion from an
anonymous donor. There is the possibility that the blood might be contaminated and
give him AIDS.