MARK ABZUG, MD

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This study examined how to prevent and treat COVID-19 in children and teenagers, recognizing that while most cases are mild, some can lead to serious illness or death. Experts analyzed data and developed recommendations based on risk factors to help identify which young patients are more likely to experience severe symptoms. Their guidance can help doctors make better treatment decisions and improve the care of affected children and teens. Who this helps: This helps children and teenagers with COVID-19 and the doctors treating them.

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This study looked at 319 children with a serious fungal infection called invasive candidiasis and found that 21% of them switched from intravenous antifungal treatment to oral antifungal therapy. Out of those, 12% later returned to intravenous treatment, mainly because their condition was getting worse. Ultimately, 66 children who switched to oral treatment responded well by the end of the study, which indicates that taking antifungal medication by mouth can be effective for some patients. Who this helps: This benefits pediatric patients with invasive candidiasis and their doctors by providing options for treatment.

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This study looked at the use of additional tests, called adjunctive diagnostic studies (aDS), in children with a fungal infection known as candidemia to check for spread of the infection. Out of 662 cases, 74% received abdominal imaging, but only a small number had positive results, like 6% for abdominal imaging and 3% for eye exams. This matters because it shows that doctors vary in how they use these tests, and most don’t find much useful information, suggesting doctors should be more selective in choosing which tests to perform. Who this helps: This helps doctors better manage and treat pediatric patients with candidemia.

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This research paper updates guidelines for using monoclonal antibody therapies to treat COVID-19 in adolescents aged 12 and older. It was found that while COVID-19 usually causes mild illness in this age group, those at high risk of severe disease should receive treatment. The experts recommend a careful approach, suggesting that at-risk adolescents with mild to moderate symptoms should be treated, and those exposed to the virus but not yet sick could also benefit from these therapies. Who this helps: This helps adolescents at high risk for severe COVID-19, as well as their doctors.

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This study looked at the growth and immune system health (measured by CD4 counts) of adolescents worldwide who were born with HIV and started treatment early. Researchers found that while some adolescents showed improvements in height over time, especially those who started treatment before age 5, many still fell short compared to their peers without HIV. Specifically, stunting (low height for age) varied by region, with 39% in Asia-Pacific but only 6% in North America and Europe, and CD4 counts dropped from an average of 768 to 607 cells/mm from ages 10 to 16 across all groups. Who this helps: This research helps adolescents living with HIV and their healthcare providers.

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This study looked at how inflammation levels change in children who were born with HIV and started treatment before age 3. Researchers analyzed data from 213 kids who successfully managed their HIV, measuring 20 different inflammatory markers over time. They found that most markers decreased as the children’s viral loads were controlled, particularly among younger, male children receiving a specific type of treatment. Who this helps: This information benefits healthcare providers treating children with HIV, helping them understand how to manage inflammation in these patients.

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This study focused on the best ways to use antiviral medications for children with COVID-19, especially those who become severely ill. The experts recommended that most children don’t need antiviral treatment, but for those with severe symptoms needing oxygen, the antiviral drug remdesivir is suggested, ideally within a clinical trial. They found that a 5-day treatment with remdesivir is appropriate and advised against using hydroxychloroquine and other similar drugs. Who this helps: This helps pediatricians and healthcare providers make informed decisions about treating children with severe COVID-19 symptoms.

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This study looked at the use of two monoclonal antibody treatments for COVID-19 in children and teenagers. The expert panel found that there is a lack of strong evidence supporting the safety and effectiveness of these treatments in younger patients. Consequently, they recommended against routinely using these therapies for kids and teens with COVID-19, even if they are considered high-risk. Who this helps: This guidance benefits children and their parents by helping ensure they receive safer, evidence-based treatment for COVID-19.

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This study looked at children in sub-Saharan Africa who were born with HIV but were successfully managing the virus with treatment. Researchers measured 23 different proteins in their blood and assessed their brain development from ages 5 to 11. They found that higher levels of certain proteins related to inflammation were linked to worse thinking and attention skills, while other proteins seemed to help improve these skills. Who this helps: This benefits children with perinatal HIV and their healthcare providers by identifying factors that affect their brain development.

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This study looked at how effective a new vaccination schedule is for kids who have received a hematopoietic stem cell transplant (HSCT). Researchers found that after revaccination, most kids had strong protection against diseases like rubella, diphtheria, and tetanus (100% protection rate), while protection was lower for measles (76%) and varicella (25%). This matters because properly vaccinating these vulnerable patients can help prevent serious illnesses that they are at higher risk of developing. Who this helps: This helps pediatric patients who have undergone HSCT and their healthcare providers.

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This study looked at how effective different antifungal treatments—specifically echinocandins compared to triazoles or amphotericin B—were for treating invasive candidiasis in children and adolescents. Out of 541 patients, those treated with echinocandins had a lower failure rate at 14 days (9.8%) compared to those using triazoles or amphotericin B (13.1%), indicating echinocandins were more effective in this timeframe. These findings are important because they may guide doctors in choosing the best initial treatment for this serious fungal infection in young patients. Who this helps: This helps children and adolescents diagnosed with invasive candidiasis and their healthcare providers.

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In 2018, there was an outbreak of enterovirus A71 (EV-A71) neurological disease in children at Children's Hospital Colorado. The study found that out of 74 affected children, 43 (58%) had EV-A71, and most symptoms included fever, signs of meningitis (93%), and rapid recovery in 93% of cases within 1-2 months. Understanding these specific symptoms and recovery patterns is important for identifying and managing future outbreaks of this disease. Who this helps: This helps doctors and healthcare professionals in recognizing and treating enterovirus-related illnesses in children more effectively.

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The research focused on how to use antiviral medications for children with COVID-19, especially since most kids experience mild cases but some can get very sick. A team of experts from 18 different North American hospitals created a set of guidelines, suggesting that most children only need supportive care, while antivirals should be considered case by case, with remdesivir as the preferred option for severe cases. This guidance helps ensure that children receive the right treatment for COVID-19 when it's necessary while minimizing unnecessary medication use. Who this helps: This benefits pediatricians and healthcare providers working with children diagnosed with COVID-19.

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Researchers studied a case of a 7-month-old baby with biliary atresia, a serious liver condition, who received a liver transplant from a living donor during the COVID-19 pandemic. They found that with careful planning and strong focus on infection control, the transplant was successful despite the challenges posed by the pandemic. This is important because it shows that living donor transplants can still be safely performed for young children in urgent need, even during difficult times. Who this helps: This helps young patients needing liver transplants and their families.

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This study looked at the use of fluoxetine, an antidepressant, to see if it could help patients with acute flaccid myelitis (AFM) caused by a specific virus called EV-D68. Researchers found that fluoxetine did not improve nerve strength over time compared to those who didn't receive the drug; in fact, patients who took fluoxetine had a decrease in strength scores, while untreated patients saw improvement. Fluoxetine was generally safe to use but did not lead to better outcomes for patients with AFM. Who this helps: This research is important for doctors treating patients with AFM, as it clarifies that fluoxetine may not be beneficial for this condition.

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This study looked at encephalitis, a serious illness in children that causes brain inflammation and neurological problems. Researchers found that in many cases, doctors could not identify a specific cause for the encephalitis, with less than half of the cases linked to an infection. This is important because it highlights the need for better understanding and treatment options for children suffering from this condition. Who this helps: This helps children with encephalitis and their doctors.

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This study looked at the use of an antifungal medication called posaconazole in young patients (ages 3 to 9) who had received blood stem cell transplants and had invasive fungal infections. The researchers found that dosing between 8.4 to 12.2 mg/kg was effective in achieving the right level of the drug in the body, and side effects were minimal. This is important because it suggests that children may need higher doses of posaconazole than adults to be effectively treated for these infections. Who this helps: This helps young patients recovering from blood stem cell transplants.

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This study looked at the connection between enterovirus D68, a virus linked to respiratory illness, and acute flaccid myelitis (AFM), a rare condition causing paralysis. Researchers found that spikes in enterovirus D68 cases in 2014 and 2016 coincided with rises in AFM cases, but proof of a direct cause is still lacking, as the virus hasn't been isolated from the spinal tissue of affected patients. Understanding this link is important for developing effective treatments and prevention methods for AFM. Who this helps: This helps patients at risk of acute flaccid myelitis and their doctors.

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This study examined adolescents who were born with HIV, looking at their health outcomes and differences across various regions around the world. Researchers analyzed data from 38,187 adolescents and found that 2.6% had died by age 15, with the highest mortality rates in South America and the Caribbean (4.4%) and the lowest in Europe (0.8%). Understanding these outcomes is important as it highlights the ongoing health disparities faced by adolescents living with HIV, especially in low-income areas. Who this helps: This benefits patients, healthcare providers, and policymakers working in HIV treatment and prevention.

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The study looked at sexually transmitted infections (STIs) among young people aged 13-24 who are living with HIV. They found that out of 1,042 young people studied, 12% had at least one STI, with human papillomavirus (HPV) and chlamydia being the most common. This is important because it highlights the need for better prevention strategies, such as promoting safe sex and ensuring young people stick to their HIV treatment. Who this helps: This helps young people living with HIV and the healthcare providers taking care of them.

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The study looked at a group of children who had received stem cell transplants to see if there was an increase in a serious eye condition called CMV retinitis. Researchers found that in 2014, five out of 28 children (18%) had CMV retinitis, while there were no cases among 101 children who had transplants from 2010 to 2013. This increase is significant and highlights the need for a new eye screening procedure for these young patients to catch the problem early, before symptoms appear. Who this helps: This helps pediatric patients who undergo stem cell transplants and their doctors.

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This study looked at the use of atorvastatin, a cholesterol-lowering medication, in HIV-infected children and young adults who have high cholesterol levels. Out of 28 participants, 63% saw improvements in their cholesterol levels after 4 weeks, with an average reduction of 30% in low-density lipoprotein (LDL) cholesterol. This is important because it shows that atorvastatin can help manage high cholesterol in this vulnerable group, although close monitoring for side effects is necessary, especially in younger patients. Who this helps: HIV-infected children and young adults with high cholesterol.

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This study examined the health risks faced by young people in the U.S. who were born with HIV as they grow older. It found that older youth (ages 13-30) experience significantly higher rates of serious health issues and death compared to younger children; for example, 30% of older participants had high viral loads, and their mortality rate was 6 to 12 times higher than that of the general U.S. population. These findings highlight the need for better treatment plans and support for these young patients to improve their long-term health. Who this helps: This helps young people living with HIV and the doctors who care for them.

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This study investigated how being infected with HIV from birth affects the timing of sexual maturation in teenagers. It found that adolescents with perinatal HIV matured about six months later than those who were not infected, with average maturity ages of 15.5 years for girls and 15.9 years for boys. The delay in maturation is largely linked to poorer growth, meaning that improving height and weight in these youths could help them mature at a more typical age. Who this helps: This helps teenagers with perinatal HIV and their healthcare providers.

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This study looked at the treatment of newborns with severe enterovirus infections, which can be deadly, using a drug called pleconaril. Out of 61 newborns in the study, those treated with pleconaril showed signs of recovery faster, taking an average of 4 days to be clear of the virus compared to 7 days for those who got a placebo. Additionally, 23% of the pleconaril group died within two months, compared to 44% in the placebo group, showing a potential survival benefit. Who this helps: This research can benefit newborns diagnosed with enterovirus sepsis and their healthcare providers.

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This study looked at a method meant to predict which children in pediatric intensive care units might get a serious fungal infection called candidemia. The researchers found that the original factors used to make this prediction did not work well in their study, showing no significant links between those factors and the infection. This matters because finding a reliable way to identify at-risk patients could help doctors provide better care and prevent infections. Who this helps: This helps doctors and healthcare providers in pediatric intensive care.

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In 2014, North America experienced its largest outbreak of enterovirus D68 (EV-D68), which primarily causes severe respiratory illness in children. Over 1,153 infections were confirmed across 49 states, though experts believe the actual number of cases could be in the millions. The outbreak led to increased hospital visits and raised concerns about connections between the virus and rare cases of paralysis in children. Who this helps: This research benefits patients, especially children, and their families by highlighting the seriousness of EV-D68 and the need for awareness and monitoring.

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This study looked at the health of 79 children with HIV who were adopted internationally or in foster care in the U.S. Most of these children came from Africa and were followed for an average of 3 years. It found that while severe immunosuppression was rare (only 1%), many children faced challenges like mental health issues (48%), educational delays (50%), and initial stunting in growth (32%), although most of this improved over time. Who this helps: This research benefits healthcare providers and adoptive families by highlighting the health needs of HIV-infected children.

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This study looks at Enterovirus-D68 (EV-D68), a virus that spreads through the respiratory system and causes breathing issues. Since 2008, there has been a rise in cases, especially during a major outbreak in North America in 2014. While treatment mainly focuses on supportive care, researchers found evidence linking EV-D68 to a serious neurological condition called acute flaccid myelitis, highlighting the need for better preparedness and research on this virus. Who this helps: This helps patients, especially children, who may be affected by respiratory and neurological illnesses caused by EV-D68.

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This study looked at a group of children in Colorado who developed sudden weakness in their limbs and problems with facial nerves after an outbreak of enterovirus D68, a virus that can cause respiratory illness. Out of the 12 affected children, many had issues like weak arms and legs, with around 83% showing serious spinal cord damage on scans. Notably, the researchers found that 45% of those tested had enterovirus D68, which raises concerns about the potential link between this virus and serious nerve problems in kids. Who this helps: This information is crucial for doctors and health professionals who treat children, as it highlights the need for better responses to similar outbreaks in the future.

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This study looked at the effects of intravenous acyclovir, a medication used to treat serious viral infections, on kidney health in children. Researchers found that 35% of the treatment courses (131 out of 373) were associated with some level of kidney dysfunction, with 3.8% developing severe kidney failure. High doses of acyclovir, older age, and the use of another antibiotic called ceftriaxone increased the risk of kidney problems, which highlights the need for careful monitoring of kidney function during treatment. Who this helps: This benefits doctors and healthcare providers treating children with serious infections.

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This study looked at the immune system recovery in 933 children and teens with HIV-1 who were receiving treatment to lower the virus in their blood. While nearly all of them reached a minimum CD4+ T-cell count of 200 after a year, 14% didn’t reach the healthier target of 500 cells even after two years. This is important because those who remain below this level are at greater risk for further health problems, despite their virus being controlled. Who this helps: This helps doctors and healthcare providers understand which children may need more support or different treatments.

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Researchers studied how effective a pandemic flu vaccine was for pregnant women who are HIV-infected, focusing on their immune system's response. They found that while the vaccine boosted flu antibodies, the immune response was weaker than in healthy adults, with only 65% of participants showing an adequate response. The study highlighted that a stronger immune response was linked to having more helper T cells and fewer exhausted B cells. Who this helps: This benefits HIV-infected pregnant women by informing better vaccination strategies for their protection against influenza.

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This study looked at young people in the US with HIV to see how their health and death rates have changed over time with the use of combination antiretroviral therapy (cART). While the study found that serious infections and deaths have decreased, the death rate for these young individuals is still very high—about 31 times higher than the general US population. Most of the deaths were linked to HIV-related health issues, and researchers identified new health problems like mental health disorders and diabetes that need attention. Who this helps: This research benefits healthcare providers and young patients living with HIV by highlighting the need for better health management and support.

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This study looked at how the immune system responds to a specific flu vaccine in pregnant women who are HIV-positive and receiving treatment. Researchers analyzed blood samples from 52 participants, finding that while most didn't show major changes after vaccination, some individuals had strong immune responses. Specifically, those with strong responses also had certain characteristics in their immune cells that could predict a better reaction to the vaccine. Who this helps: This helps HIV-infected pregnant women by providing insights into how their immune systems respond to vaccinations.

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This study looked at invasive mold infections (IMIs) in children, specifically how common they are, the treatments used, and the outcomes for 131 children affected by these infections between 2007 and 2011. Most of the infections were caused by a type of mold called Aspergillus, and although using a combination of antifungal drugs was common, it doubled the risk of negative side effects without improving recovery. This research is important because it highlights the need for careful consideration of treatment options for these serious infections. Who this helps: This helps doctors treating immunocompromised children at risk for mold infections.

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This study examined the effects of a medication called valganciclovir on newborns with symptomatic congenital cytomegalovirus (CMV) disease. Researchers compared giving the drug for 6 months versus just 6 weeks and found that while short-term hearing outcomes were similar, longer-term hearing improved more in those treated for 6 months (73% improved or stayed normal at 12 months compared to 57% in the 6-week group) and had better developmental scores (like language skills). These findings highlight the potential for longer treatment to lead to better hearing and development outcomes over time. Who this helps: This benefits newborns with symptomatic congenital CMV disease and their families.

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This study focused on enteroviruses, which can cause serious illnesses like polio and hand-foot-mouth disease, especially in infants and young children. Researchers found that while some antiviral treatments are in progress, such as pleconaril and V-073, there is still no effective therapy specifically available for most enterovirus infections. Developing these treatments is crucial because enteroviruses can lead to conditions like severe neurological issues and respiratory failure in vulnerable populations. Who this helps: This helps infants, young children, and their healthcare providers.

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This study looked at whether antibiotics help treat acute sinusitis in children. Researchers found that while antibiotics can clear bacteria from the sinuses, there is only a small benefit in actually improving symptoms, with 60-65% of children recovering without them. This is important because it raises questions about when to use antibiotics to prevent complications, but the evidence is still unclear. Who this helps: This helps pediatricians and parents of children with sinusitis.

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This study looked at the rates of a serious ear infection called acute mastoiditis in young children in Colorado from 1999 to 2008, especially after the pneumococcal conjugate vaccine (PCV) was introduced. They found that the rate dropped from 11 cases per 100,000 children under 2 years old in 2001 to about 4.5 in 2003 but then rose again to 12 cases per 100,000 by 2008. This increase may be due to changes in the types of bacteria causing infections and increased resistance to antibiotics. Who this helps: This information benefits doctors treating young children with ear infections, guiding them in the use of antibiotics.

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This study looked at the right dose of the flu medication oseltamivir for children under 2 years old. It found that infants up to 8 months should receive a dose of 3.0 mg/kg, and those aged 9-11 months should get 3.5 mg/kg to ensure they get enough of the medication to fight the flu. Some children on the standard dose did not get enough of the drug, and a few developed resistance to it, which is concerning. Who this helps: This helps young children with influenza by ensuring they receive the right dosage of medication.

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This study looked at how safe and effective the 2009 H1N1 flu vaccine is for pregnant women who are HIV-positive. The researchers found that two doses of the vaccine did not cause serious side effects and helped 80% of the women develop a protective immune response after the second dose. However, while many mothers had protective antibodies at birth, these antibodies quickly decreased in their infants over time. Who this helps: This benefits HIV-infected pregnant women and their newborns by providing them with better protection against the flu.

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This study focused on how well pneumococcal vaccines work over time in children with HIV who are receiving treatment. Researchers found that 4-5 years after initial vaccinations, 41% to 82% of the children still had enough protective antibodies, depending on the vaccine type, and after receiving a booster shot, most showed a good immune response. These findings are important because they show that these vaccines can provide lasting protection and help guide future vaccination strategies for HIV-infected children. Who this helps: This helps HIV-infected children and their healthcare providers.

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This study looked at when children with HIV from birth start to enter puberty compared to those who weren't infected. Researchers found that the average age of puberty was later for children with perinatal HIV (about 10.3 years for girls and 11.5 years for boys) compared to those without the virus (9.6 years for girls and 10.7 years for boys). The timing of puberty was even later for kids with more severe HIV, but using antiretroviral treatment could help bring their puberty timing closer to normal. Who this helps: This benefits children with HIV and their healthcare providers.

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The study focused on creating updated guidelines for preventing and treating opportunistic infections (OIs) in children exposed to or infected with HIV in the U.S. The expert panel reviewed recent research and made specific recommendations based on their findings, which include updated protocols for managing these infections since the last guidelines were released in 2009. This is important because it helps ensure that healthcare providers have the best and most current strategies to protect the health of these vulnerable children. Who this helps: This benefits doctors and healthcare providers working with HIV-exposed and HIV-infected children.

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This report summarizes the updated guidelines for preventing and treating infections in children who are exposed to or infected with HIV, released by the Department of Health and Human Services in 2013. The guidelines were developed by pediatric specialists who reviewed the latest research and provided updated recommendations for treating opportunistic infections; they will keep evolving as new treatments become available. This is important because it helps ensure that children receive the best and most current care possible. Who this helps: This benefits healthcare providers who treat HIV-exposed and HIV-infected children.