A5053010060- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Respiratory viral infections research
- HIV-related health complications and treatments
- Cytomegalovirus and herpesvirus research
- HIV/AIDS drug development and treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- Parvovirus B19 Infection Studies
- Pneumonia and Respiratory Infections
- Immune Cell Function and Interaction
- Immunodeficiency and Autoimmune Disorders
- Breastfeeding Practices and Influences
- Parasitic Diseases Research and Treatment
- Viral gastroenteritis research and epidemiology
- Insects and Parasite Interactions
- COVID-19 Clinical Research Studies
- Immune responses and vaccinations
- Infant Nutrition and Health
- Child Nutrition and Feeding Issues
- Herpesvirus Infections and Treatments
- Food Security and Health in Diverse Populations
- Hepatitis Viruses Studies and Epidemiology
- Neonatal Respiratory Health Research
- Migration, Health and Trauma
- COVID-19 Impact on Reproduction
University of Colorado Anschutz Medical Campus
2018-2025
University of Colorado Denver
2016-2025
Children's Hospital Colorado
2015-2023
There are limited pediatric data regarding severe COVID-19 disease. Our study aims to describe the epidemiology and identify risk factors for disease in children.This is a retrospective cohort among children with positive SARS-CoV-2 PCR from March July 2020 at Children's Hospital Colorado. Risk were analyzed as defined by hospital admission, respiratory support, or critical care. Univariable multivariable analyses conducted.Among 454 patients identified SARS-CoV-2, 191 (42.1%) females,...
The distribution of upper respiratory viral loads (VL) in asymptomatic children infected with severe acute syndrome coronavirus 2 (SARS-CoV-2) is unknown. We assessed PCR cycle threshold (Ct) values and estimated VL diagnosed nine pediatric hospital testing programs. Records for symptomatic patients positive clinical SARS-CoV-2 tests were reviewed. Ct (i) adjusted by centering each value around the institutional median from tested that assay (ii) converted to (numbers copies per milliliter)...
Pediatricians and pediatric health care professionals caring for infants born to people living with at risk HIV infection are likely be involved in providing guidance on recommended infant feeding practices. Care team members need aware of the transmission from breastfeeding recommendations perinatal exposure United States. The via a parent who is receiving antiretroviral treatment (ART) virally suppressed estimated less than 1%. American Academy Pediatrics recommends that States, avoidance...
<sec><title>Background</title><p>Hispanic ethnicity is associated with an increased risk for severe disease in children COVID-19. Identifying underlying contributors to this disparity can lead improved health care utilization and prevention strategies.</p></sec><sec><title>Methods</title><p>This a retrospective cohort study of 2–20 years age positive SARS-CoV-2 testing from March–October 2020. Univariable multivariable logistic...
Abstract Respiratory syncytial virus (RSV) is a major contributor to morbidity and mortality in infants. We developed an vitro model of human respiratory infection study cellular immune responses RSV infants, children, adults. The includes lung epithelial A549 cells or fetal fibroblasts infected with clinical strain at multiplicity 0.3, cocultured cord blood mononuclear (CBMCs) peripheral (PBMCs). Mononuclear were collected multiple ages ranging from birth adulthood. After 20 h incubation,...
This case-series describes the 6 human infections with Onchocerca lupi, a parasite known to infect cats and dogs, that have been identified in United States since 2013. Unlike cases reported outside country, American patients not had subconjunctival nodules but manifested more invasive disease (eg, spinal, orbital, subdermal nodules). Diagnosis remains challenging absence of serologic test. Treatment should be guided by what is done for volvulus as there are no data O. lupi. Available...
Studies from multiple countries have suggested impaired immunity in perinatally human immunodeficiency virus (HIV)-exposed uninfected children (HEU), with elevated rates of all-cause hospitalization and infections. We estimated compared the incidence infection-related first 2 years life among HEU HIV-unexposed (HUU) United States. Among HEU, we evaluated associations maternal HIV disease-related factors during pregnancy risk child hospitalization.
Background: Women with HIV in high-income settings have increasingly expressed a desire to breastfeed their infants. Although national guidelines now acknowledge this choice, detailed recommendations are not available. We describe the approach managing care for breastfeeding women at single large-volume site United States. Methods: convened an interdisciplinary group of providers establish protocol intended minimize risk vertical transmission during breastfeeding. Programmatic experience and...
Objectives: HIV-exposed uninfected (HEU) infants have higher rates of severe and fatal infections compared with HIV-unexposed (HUU) infants, likely due to immune perturbations. We hypothesized that alterations in natural killer (NK) cell activity might occur HEU predispose them infections. Design: Case-control study using cryopreserved peripheral blood mononuclear cells (PBMCs) at birth 6 months from enrolled 2002-2009 HUU 2011-2013. Methods: NK phenotype function were assessed by flow...
Background: Data are lacking on the impact of different severe acute respiratory syndrome coronavirus 2 variants in children and pediatric vaccine effectiveness. We examined differences among requiring hospital admission associated with disease 2019 (COVID-19) during wild type, Delta Omicron variant periods calculated effectiveness at preventing symptomatic hospitalization periods. Methods: conducted a retrospective review younger than 21 years age hospitalized COVID-19. Characteristics were...
Abstract Unlike other respiratory viruses, SARS-CoV-2 disproportionately causes severe disease in older adults whereas burden children is lower. To investigate whether differences the upper airway immune response may contribute to this disparity, we compare nasopharyngeal gene expression 83 (<19-years-old; 38 with SARS-CoV-2, 11 34 no virus) and 154 (>40-years-old; 45 28 81 virus). Expression of interferon-stimulated genes robustly activated both infection compared respective non-viral...
Six weeks of zidovudine (ZDV) is recommended for postnatal prophylaxis HIV-exposed infants, but combination antiretrovirals are indicated if HIV transmission risk increased. We investigated the frequency and severity adverse events (AE) in infants receiving multiple drug compared to ZDV alone. In this retrospective review 148 uninfected born between 1997–2009, we determined clinical laboratory AE that occurred days life 8–42. Thirty-six received prophylaxis; among those, a three-drug regimen...
We examined associations between B and T cell phenotypic profiles antibody responses to the pentavalent rotavirus vaccine (RV5) in perinatally HIV-infected infants (PHIV) on antiretroviral therapy HIV-exposed uninfected (PHEU) enrolled IMPAACT P1072 study (NCT00880698). Of 17 subsets analyzed, PHIV PHEU differed only number of CD4+ cells frequency naive cells, which were higher than PHIV. In contrast, markedly from those geographically-matched contemporary HIV-unexposed infants. The...
To identify factors that predispose human immunodeficiency virus (HIV)-exposed uninfected infants (HEUs) to higher incidence of severe infections, hospitalization, and death in the first 6-24 months life compared with HEUs without lower respiratory tract infection (LRTI) 6 life. Nested case-control study 107 LRTI+ enrolled International Site Development Initiative (NISDI) Perinatal Longitudinal Study Latin American Countries (LILAC) studies 140 LRTI- months, matched by date place birth....
Human immunodeficiency virus (HIV)-exposed, uninfected (HEU) infants experience high rates of infectious morbidity. We hypothesized that early cytomegalovirus (CMV) infection was associated with increased hospitalization and decreased vaccine responses in HEU compared HIV-unexposed (HUU) infants.
Objectives: Data are lacking on the virologic efficacy and durability of modern antiretroviral treatment (ART) regimens during pregnancy. We compared outcomes at delivery among women receiving dolutegravir versus other ART rate change initial pregnancy regimen. Design: Single site retrospective cohort between 2009-2019. Methods: used univariable multivariable generalized estimating equations to model relationship maternal anchor proportion with a viral load ≥20 HIV RNA copies/mL plasma...
Background Antiretroviral therapy (ART) decreases perinatal HIV transmission, but concerns exist regarding maternal and infant safety. We compared the incidence of congenital malformations other adverse outcomes in pregnancies exposed to integrase inhibitor (INSTI) versus non-INSTI ART. Setting Single-site review all among women living with between 2008 2018. Methods used binomial family generalized estimating equations model relationship anomalies pregnancy exposure INSTI or dolutegravir...
Christiana Smith, Cullen Dutmer, D. Scott Schmid, Megan K. Dishop, William J. Bellini, Erwin W. Gelfand, and Edwin Asturias Departments of Pediatric Infectious Diseases; Pathology, University Colorado School Medicine, Aurora; Department Allergy Clinical Immunology, National Jewish Health, Denver, Colorado; Division Viral Diseases, Center for Immunization Respiratory Centers Disease Control Prevention, Atlanta, Georgia; Global Public Aurora
Abstract Background Human immunodeficiency virus (HIV)–exposed, uninfected (HEU) infants experience higher rates of morbidity and mortality than HIV-unexposed, (HUU) infants. Few studies have examined whether particular infections and/or immune responses are associated with hospitalization among HEU born in the United States. Methods We evaluated a subset enrolled International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1025 HIV/AIDS Cohort Study Surveillance Monitoring for...
A previously healthy 11-year-old female, who emigrated from Central America four years prior, was admitted with eight days of fever, night sweats, and anorexia. Past medical history included severe bronchiolitis, varicella, hepatitis as a child. Upon admission, her physical exam significant for nontender cervical lymphadenopathy, intermittent erythematous papules on the upper extremities, mild abdominal tenderness. Initial laboratory studies revealed leukopenia, anemia, elevated inflammatory...