Henry J Pollack, M.D.

Prolonged therapy with adefovir dipivoxil in children with chronic hepatitis B
Jonas M.M.; Kelly D.A.; Pollack H.; Mizerski J.; Sorbel J.; Mondou E.; Sokal E.M.
2011 ;54:703A-703A, Hepatology
Objectives: To examine the therapeutic effects, the frequency of viral resistance and safety after prolonged ADV therapy in children with chronic hepatitis B (CHB.) Background: The safety and efficacy of adefovir dipivoxil (ADV) for CHB in children was reported several years ago after a randomized, doubleblind placebo (PLB)-controlled trial. Subsequently, ADV was licensed in the United States for use in children age 12 and older. The cohort of children and adolescents in the placebocontrolled study was followed for an additional 4 years, and many of the children remained on ADV for all or part of this time. This is the only report of the use of adefovir dipivoxil longterm in a pediatric cohort. Methods: After 48 weeks of doubleblind treatment, all placebo-treated subjects who did not exhibit HBeAg seroconversion at week 44, and all ADV-treated subjects, were offered open-label ADV for up to an additional 192 weeks. Treatment was discontinued if there was no virologic effect, except for adolescents with previous lamivudine exposure, in whom lamivudine was added to ADV. Subjects who achieved HBeAg seroconversion were followed in order to assess durability of seroconversion. Annual resistance surveillance was conducted for all subjects who had detectable HBV DNA levels. Result: Of the 170 subjects who completed the 48- week study, 162 participated in the open-label study. ADV was discontinued in 61 of 162 due to virologic failure. In subjects who continued treatment, either as monotherapy or with lamivudine, continued viral suppression and ALT normalization were noted. HBeAg seroconversions were observed in 54 subjects, and HBsAg seroconversion in 5 children. ADV was safe and well-tolerated. Resistance to ADV was observed in 1 child on ADV monotherapy. Nine treatment-experienced subjects entered the study with mutations associated with lamivudine. All nine subjects responded to ADV therapy. Conclusions: ALT normalization was common and continued HBeAg and HBsAg seroconversions were observed in children who received ADV for up to 5 years. Prolonged ADV treatment is safe in children. ADV may have utility in the treatment of chronic HBV infection in children. It should be reserved for those with virologic response
— id: 142063, year: 2011, vol: 54, page: 703A, stat: Journal Article,

A comprehensive screening and treatment model for reducing disparities in hepatitis B
Pollack, Henry; Wang, Su; Wyatt, Laura; Peng, Chia-Hui; Wan, Kejia; Trinh-Shevrin, Chau; Chun, Kay; Tsang, Thomas; Kwon, Simona
2011 Oct;30(10):1974-1983, Health affairs
Chronic hepatitis B affects Asian Americans at a much higher rate than the general US population. Appropriate care can limit morbidity and mortality from hepatitis B. However, access to care for many Asian Americans and other immigrant groups is limited by their lack of knowledge about the disease, as well as cultural, linguistic, and financial challenges. This article describes the results of BfreeNYC, a New York City pilot program that, from 2004 to 2008, provided hepatitis B community education and awareness, free screening and vaccinations, and free or low-cost treatment primarily to immigrants from Asia, but also to residents from other racial and ethnic minority groups. The program was the largest citywide screening program in the United States, reaching nearly 9,000 people, and the only one providing comprehensive care to those who were infected. During the program, new hepatitis B cases reported annually from predominantly Asian neighborhoods in the city increased 34 percent. More than two thousand people were vaccinated, and 1,162 of the 1,632 people who tested positive for hepatitis B received care from the program's clinical services. Our analysis found that the program was effective in reaching the target population and providing care. Although follow-up care data will be needed to demonstrate long-term cost-effectiveness, the program may serve as a useful prototype for addressing hepatitis B disparities in communities across the United States
— id: 140022, year: 2011, vol: 30, page: 1974, stat: Journal Article,

A simulation shows that early treatment of chronic hepatitis B infection can cut deaths and be cost-effective
Post, Sarah E; Sodhi, Neetu Khurana; Peng, Chia-Hui; Wan, Kejia; Pollack, Henry J
2011 Feb;30(2):340-348, Health affairs
Chronic hepatitis B affects between 800,000 and two million people in the United States and causes 4,000 deaths each year. Yet the costs and benefits of treatment have not been fully evaluated. Using a model that simulates disease progression, we compare treatment programs for hepatitis B that start at an early stage of the disease to treatment that begins at a late stage. Our analysis concludes that early hepatitis B care can improve health, reduce premature deaths, and prevent expensive complications, making it highly cost-effective in the long term. Our results demonstrate the importance of screening for hepatitis B among at-risk groups and then linking screening to treatment. They also illustrate how predictive models can be used to evaluate strategies for improving access to care
— id: 134216, year: 2011, vol: 30, page: 340, stat: Journal Article,

The asian american hepatitis B program: building a coalition to address hepatitis B health disparities
Trinh-Shevrin, Chau; Pollack, Henry J; Tsang, Thomas; Park, Jihyun; Ramos, Mary Ruchel; Islam, Nadia; Wang, Su; Chun, Kay; Sim, Shao-Chee; Pong, Perry; Rey, Mariano Jose; Kwon, Simona C
2011 Fall;5(3):261-271, Progress in community health partnerships : research, education, & action
Background: Community coalitions are increasingly recognized as important strategies for addressing health disparities. By providing the opportunity to pool resources, they provide a means to develop and sustain innovative approaches to affect community health. Objectives: This article describes the challenges and lessons learned in building the Asian American Hepatitis B Program (AAHBP) coalition to conduct a community-based participatory research (CBPR) initiative to address hepatitis B (HBV) among New York City Asian-American communities. Methods: Using the stages of coalition development as a framework, a comprehensive assessment of the process of developing and implementing the AAHBP coalition is presented. Lessons Learned: Findings highlight the importance of developing a sound infrastructure and set of processes to foster a greater sense of ownership, shared vision, and investment in the program. Conclusion: Grassroots community organizing and campus-community partnerships can be successfully leveraged to address and prevent a significant health disparity in an underserved and diverse community
— id: 143334, year: 2011, vol: 5, page: 261, stat: Journal Article,

Hepatitis B virus in the United States
Wang, Su H; Pong, Perry; Pollack, Henry
2011 Aug 2;155(3):204-205, Annals of internal medicine
— id: 143335, year: 2011, vol: 155, page: 204, stat: Journal Article,

CHARACTERIZATION OF THE IMMUNE RESPONSE TO THE LARVAL PHASE OF ASCARIS SUUM INFECTION AND IDENTIFICATION OF ASCARIS ANTIGENS EXPRESSED DURING THAT PHASE
Fernandez, MAG; Pollack, HJ; Eichinger, D; Hotez, PJ
2009 NOV ;81(5):134-134, American journal of tropical medicine & hygiene
— id: 106986, year: 2009, vol: 81, page: 134, stat: Journal Article,

Chemokine IP-10: an adjunct marker for latent tuberculosis infection in children
Lighter, Jennifer; Rigaud, M; Huie, M; Peng, C-H; Pollack, H
2009 Jun;13(6):731-736, International journal of tuberculosis & lung disease
SETTING: Recent reports indicate a role of chemokine inducible protein 10 (IP-10) in Mycobacterium tuberculosis infection substantiated by the detection of elevated levels in plasma and at infection foci in individuals infected with M. tuberculosis. OBJECTIVE: To evaluate IP-10 as a potential marker for the diagnosis of M. tuberculosis infection in children living in a region of low tuberculosis (TB) prevalence. DESIGN: IP-10 levels were obtained after whole blood stimulation with M. tuberculosis-specific antigens in 127 children. IP-10 results were evaluated upon gradations of exposure risk to M. tuberculosis and correlation with tuberculin skin test and an interferon-gamma release assay (IGRA). RESULTS: IP-10 reactivity correlated well to risk of exposure to M. tuberculosis in children. There was a strong correlation between IP-10 and IGRA results. IP-10 responses, unlike interferon-gamma (IFN-gamma), were not age-dependent and detected more positive results in children aged <5 years. In the children with active disease, the IGRA was more sensitive than IP-10 at detecting M. tuberculosis infection. CONCLUSION: Our findings suggest that IP-10 in combination with IFN-gamma may enhance the diagnostic performance of IGRAs in detecting M. tuberculosis infection, especially in young children
— id: 99145, year: 2009, vol: 13, page: 731, stat: Journal Article,

Latent tuberculosis diagnosis in children by using the QuantiFERON-TB Gold In-Tube test
Lighter, Jennifer; Rigaud, Mona; Eduardo, Roger; Peng, Chia-Hui; Pollack, Henry
2009 Jan;123(1):30-37, Pediatrics
BACKGROUND: The QuantiFERON-TB Gold test was the first blood test to be approved for the diagnosis of latent tuberculosis infection. Although it has been shown to be sensitive and specific in adults, limited data on its performance in children are available. METHODS: This was a prospective study of children receiving health care in New York, New York. Each child was assessed for risk factors for Mycobacterium tuberculosis infection, underwent tuberculin skin testing, and had a QuantiFERON-TB Gold In-Tube test performed. The concordance between tuberculin skin test and QuantiFERON-TB Gold In-Tube test results was calculated, and the results were analyzed according to the likelihood of exposure to M tuberculosis. RESULTS: Data for 207 children with valid tuberculin skin test and QuantiFERON-TB Gold In-Tube test results were analyzed. There was excellent correlation between negative tuberculin skin test results and negative QuantiFERON-TB Gold In-Tube test results; however, only 23% of children with positive tuberculin skin test results had positive QuantiFERON-TB Gold In-Tube test results. Positive QuantiFERON-TB Gold In-Tube test results were associated with increased likelihood of M tuberculosis exposure, and interferon gamma levels were higher in children with known recent exposure to M tuberculosis, compared with children with older exposure histories. Younger children produced lower interferon gamma levels in response to the mitogen (phytohemagglutinin) control used in the QuantiFERON-TB Gold In-Tube test, but indeterminant results were low for children of all ages. Performance characteristics were similar across all age groups. CONCLUSION: The QuantiFERON-TB Gold In-Tube test is a specific test for M tuberculosis exposure in children, with performance characteristics similar to those for adults residing in regions with low levels of endemic disease. Concerns about test sensitivity, especially for children <2 years of age, will require additional prospective long-term evaluation
— id: 92690, year: 2009, vol: 123, page: 30, stat: Journal Article,

Role of imiquimod and parenteral meglumine antimoniate in the initial treatment of cutaneous leishmaniasis
Arevalo, Iracema; Tulliano, Gianfranco; Quispe, Ana; Spaeth, Gerald; Matlashewski, Greg; Llanos-Cuentas, Alejandro; Pollack, Henry
2007 Jun 15;44(12):1549-1554, Clinical infectious diseases
BACKGROUND: Cutaneous leishmaniasis is a serious public health problem in the developing world. The main therapeutic agent--pentavalent antimony, developed >50 years ago--is expensive, often accompanied by severe adverse effects, and complicated by the emergence of drug resistance. Better therapies are urgently needed. In the present pilot study, we compared the use of imiquimod, an immunomodulatory molecule, to the use of meglumine antimoniate alone and in combination for the initial treatment of cutaneous leishmaniasis. MATERIALS AND METHODS: Patients with newly diagnosed cutaneous leishmaniasis were enrolled from a single referral center in Lima, Peru, from August 2005 through October 2005. Patients were randomly assigned to 1 of 3 treatment groups and received either imiquimod 7.5% cream administered topically every other day for 20 days, intravenous meglumine antimoniate administered at a dosage of 20 mg/kg per day every day for 20 days, or combination therapy with both intravenous meglumine antimoniate and imiquimod 7.5% cream. Patients were evaluated weekly and at 1 and 3 months after treatment. Patients who had healed lesions at 3 months were considered to be clinically cured. RESULTS: Although several patients showed initial resolution of symptoms with imiquimod treatment alone, all of these patients experienced relapse after treatment discontinuation. Four (57%) of 7 patients treated with meglumine antimoniate alone and 7 (100%) of 7 patients treated with combination therapy were cured. Combination therapy was not only more effective than the other 2 treatments (P<.05) but also led to faster healing and better cosmetic results. CONCLUSION: Combination therapy with imiquimod and meglumine antimoniate is a promising regimen for the initial treatment of cutaneous leishmaniasis that warrants additional larger studies.
— id: 72968, year: 2007, vol: 44, page: 1549, stat: Journal Article,

Management of chronic hepatitis B virus (HBV)infection by primary care physicians in urban hospitals and clinics in New York city
Pollack, H; Won, K; Miyoshi, T; Tawdekar, S; Baker, P; McEwen, D; Weinbaum, C; Bialek, SR; Fryer, G; Low, R
2007 OCT ;46(4):676A-676A, Hepatology
— id: 75128, year: 2007, vol: 46, page: 676A, stat: Journal Article,

Screening for hepatitis B virus (HBV) infection by primary care physicians in New York city: Are screening recommendations for persons born in endemic countries being followed?
Wan, K; Miyoshi, T; Fryer, G; Tawdekar, S; Baker, P; McEwen, D; Weinbaum, C; Bialek, SR; Low, R; Pollack, H
2007 OCT ;46(4):889A-890A, Hepatology
— id: 75129, year: 2007, vol: 46, page: 889A, stat: Journal Article,

Screening for chronic hepatitis among Asian/Pacific islanders populations - New York city
Pollack, H.
2006 MAY 12 ;55(18):505-509, MMWR
— id: 69042, year: 2006, vol: 55, page: 505, stat: Journal Article,

Clinical characteristics of Asian Americans infected with hepatitis B diagnosed by community-based screenings in New York City
Pollack, H; Sherman, A; Tsang, T; Wan, K; Lupatkin, H; Villaneuva, G; Tso, A; Angela, T; Michael, P; Pearl, K; Ruchel, R; Rey, M; Tobias, H
2006 OCT ;44(4):568A-568A, Hepatology
— id: 70934, year: 2006, vol: 44, page: 568A, stat: Journal Article,

An epidemiologic study of hepatitis B virus infection among Asian Americans in New York City
Wan, K; Chen, Y; Tsang, T; Sherman, A; Tso, A; Korenblit, P; Son, S; Poon, E; Ramos, R; Tobias, H; Rey, M; Pollack, H
2006 JUN 1 ;163(11):S252-S252, American journal of epidemiology
— id: 68859, year: 2006, vol: 163, page: S252, stat: Journal Article,

Mass screenings in New York City reveal extraordinarily high prevalence of hepatitis B in an urban Asian population
Sherman, A; Tsang, T; Villaneuva, G; Pollack, H; Tobias, H
2005 OCT ;42(4):214A-214A, Hepatology
— id: 59260, year: 2005, vol: 42, page: 214A, stat: Journal Article,

Development of a molecular-beacon assay to detect the G1896A precore mutation in hepatitis B virus-infected individuals
Waltz, Therese L; Marras, Salvatore; Rochford, Gemma; Nolan, John; Lee, Eugenia; Melegari, Margherita; Pollack, Henry
2005 Jan;43(1):254-258, Journal of clinical microbiology
The 1896 precore (PC) mutation is the most frequent cause of hepatitis B virus e-antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection. Detection of the 1896 PC mutation has application in studies monitoring antiviral therapy and the natural history of the disease. Identification of this mutation is usually performed by direct sequencing, which is both costly and laborious. The aim of this study was to develop a rapid, high-throughput assay to detect the 1896 PC mutation using real-time PCR and molecular-beacon technology. The assay was initially standardized on oligonucleotide targets and plasmids containing the wild-type (WT) and PC mutation and then tested on plasma samples from children with HBV DNA of >10(6) copies/ml. Nine individuals were HBeAg negative and suspected to harbor HBeAg mutations, while 12 children were HBeAg positive and selected as controls. Ninety percent (19 of 21) of plasma samples tested with molecular beacons were in complete agreement with sequencing results. The remaining 10% (2 of 21) of samples were identified as heterogeneous mixtures of WT and mutant virus by molecular beacons, though sequencing found only a homogeneous mutant in both cases. Overall, the 1896 PC mutation was detected by this assay in 55.5% of the children with HBeAg-negative infection. In summary, this assay is a rapid, sensitive, and specific technique that effectively discriminates WT from 1896 PC mutant HBV and may be useful in clinical and epidemiological studies
— id: 48883, year: 2005, vol: 43, page: 254, stat: Journal Article,

Perinatal Transmission and Viral Evolution of Hepatitis C Virus Quasispecies in Infants Coinfected With HIV
Pollack, Henry; Hou, Zhiying; Hughes, Austin L; Borkowsky, William
2004 Aug 1;36(4):890-899, Journal of acquired immune deficiency syndromes. JAIDS
OBJECTIVES:: Three HIV/hepatitis C virus (HCV)-coinfected children and the mothers of 2 were studied to examine the nature of perinatal HCV infection in HIV-coinfected infants and to assess the evolution of viral quasispecies thereafter. Sequences of the hypervariable region in the N terminus of the E2/NS1 region (HVR-1) of the children and their mothers were compared. HCV quasispecies changes in the infants were tracked over several years. METHODS:: Sequence similarity comparisons and phylogenetic trees were derived from cDNA of plasma isolates. Quantitation of plasma HCV and HIV was performed in the children, as well as CD4 T-cell percentage and liver transaminases. RESULTS:: Phylogenetic analysis of the mother-child pairs suggested that transmission of multiple dominant and nondominant variants identified in the mother were seen. HCV diversification in the children was seen as early as 2 months of life. The child with the best immune status and HIV control demonstrated the most diversification throughout. CONCLUSION:: Multiples HCV variants transmitted from mother to child and their early changes in the child may be related to maternal antibody. Variation after the 1st year of life may reflect immunologic pressure from the child. There was no trend suggesting that the presence or absence of selective immunologic pressure affected HCV load or liver transaminase values
— id: 55985, year: 2004, vol: 36, page: 890, stat: Journal Article,

Response to Lamivudine Treatment in Children with Chronic Hepatitis B Virus Infection
Hagmann, Stefan; Chung, May; Rochford, Gemma; Jani, Mudra; Trinh-Shevrin, Chau; Sitnitskaya, Yekaterina; Neumann, Avidan U; Pollack, Henry
2003 Dec 1;37(11):1434-1440, Clinical infectious diseases
Despite the recent approval of lamivudine for the treatment of children with chronic hepatitis B virus (HBV) infection, there is insufficient information on the kinetics of HBV clearance and the factors that predict a favorable treatment response to lamivudine in this population. In a small retrospective study of 16 HBV-infected children treated with lamivudine, we examined changes in virus load and other factors associated with hepatitis B e antigen (HBeAg) clearance. High pretherapy alanine aminotransferase level, low serum HBV DNA load, and age at the start of treatment were independently associated with HBeAg clearance. HBeAg clearance was also associated with the achievement of specific levels of virus suppression, and failure to achieve those levels was associated with the development of lamivudine resistance. Additional studies are necessary to provide better indications and guidelines for the treatment of children with chronic HBV infection
— id: 38996, year: 2003, vol: 37, page: 1434, stat: Journal Article,

Recombinant glycoprotein vaccines for human immunodeficiency virus-infected children and their effects on viral quasispecies
Essajee, Shaffiq M; Yogev, Ram; Pollack, Henry; Greenhouse, Bryan; Krasinski, Keith; Borkowsky, William
2002 Jan;9(1):79-82, Clinical & diagnostic laboratory immunology
In individuals infected with human immunodeficiency virus type 1 (HIV-1), specific immunity is associated with a more diverse viral repertoire and slower disease progression. Attempts to enhance antiviral immunity with therapeutic vaccination have shown that recombinant glycoprotein (RGP) vaccines are safe, well tolerated, and immunogenic, but the effect of RGP vaccines on the viral repertoire is unknown. We evaluated diversification of the viral envelope in 12 HIV-infected children who received placebo or RGP vaccines. At baseline, 11 of 12 patients had multiple viral variants. On follow-up 6 months later, children who had a strong vaccine-associated lymphoproliferative immune response showed less viral diversification than those in whom the immune response was weak or absent. These results suggest that the immune response elicited by RGP vaccines does not exert a significant selection pressure on the viral quasispecies and therefore may not be helpful in changing the course of the disease
— id: 39732, year: 2002, vol: 9, page: 79, stat: Journal Article,

Immunoreconstitution in children receiving highly active antiretroviral therapy depends on the CD4 cell percentage at baseline
Nikolic-Djokic, Divna; Essajee, Shaffiq; Rigaud, Mona; Kaul, Aditya; Chandwani, Sulachni; Hoover, William; Lawrence, Robert; Pollack, Henry; Sitnitskaya, Yekaterina; Hagmann, Stefan; Jean-Philippe, Patrick; Chen, Song He; Radding, Jayme; Krasinski, Keith; Borkowsky, William
2002 Feb 1;185(3):290-298, Journal of infectious diseases
The effect of highly active antiretroviral therapy (HAART) in 85 children infected with human immunodeficiency virus type 1 (HIV-1) was compared retrospectively among Centers for Disease Control and Prevention (CDC) immunologic groups 1-3. The duration of HAART did not vary significantly among the immunologic groups (median, 39.07 months). The CD4 cell percentage increased in 39.1%, 58.3%, and 90% of patients in CDC groups 1-3, respectively (P <.001). HAART resulted in the suppression of HIV-1 below detectable levels in 34.8%, 25%, and 32% of patients in the 3 CDC groups, respectively, and in a frequent switch from syncytium-inducing to nonsyncytium-inducing virus. Thymic excision circles increased in a subset of patients with increases in CD4 cell percentage independently of HIV RNA level. The results support the option of delaying HAART in early asymptomatic HIV-1 disease in children and the use of other markers of disease progression, in addition to virus load
— id: 42231, year: 2002, vol: 185, page: 290, stat: Journal Article,

Pre-treatment and early treatment predictors of eAg clearance in HBV-infected children treated with lamivudine
Pollack, H; Hagmann, S; Neumann, AU; Chung, M; Rochford, G; Lau, C; Trinh-Sherin, C
2002 DEC ;7(4):L95-L96, Antiviral therapy
— id: 37140, year: 2002, vol: 7, page: L95, stat: Journal Article,

Hepatitis C virus (HCV)-specific immune responses and viral load in HIV-1/HCV co-infected individuals before and after interferon-alpha 2a therapy
Anandasabapathy, S; Nikolic-Djokic, D; Dorante, G; Flynn, SM; Pollack, H; Borkowsky, W; Talal, AH
2001 OCT ;34(4):485A-485A, Hepatology
— id: 54868, year: 2001, vol: 34, page: 485A, stat: Journal Article,

Pneumocystis carinii infection presenting as an intra-abdominal cystic mass in a child with acquired immunodeficiency syndrome
Hagmann S; Merali S; Sitnitskaya Y; Fefferman N; Pollack H
2001 Oct 15;33(8):1424-1426, Clinical infectious diseases
We describe the case of a pediatric patient with acquired immunodeficiency syndrome (AIDS) with an unusual large, fluid-filled intra-abdominal cystic lesion in which Pneumocystis carinii trophozoites were identified. Extrapulmonary P. carinii infection should be considered in the differential diagnosis of an intra-abdominal cystic mass in a child with AIDS
— id: 26617, year: 2001, vol: 33, page: 1424, stat: Journal Article,

Response to lamivudine therapy in children chronically infected with hepatitis B virus (HBV)
Hagmann, S; Chung, M; Rochford, G; Jani, M; Sitnitskaya, Y; Pollack, H
2001 OCT 1 ;33(7):1161-1161, Clinical infectious diseases
— id: 54857, year: 2001, vol: 33, page: 1161, stat: Journal Article,

Prevalence of the t215y mutation in human immunodeficiency virus type 1-infected pregnant women in a new york cohort, 1995-1999
Sitnitskaya Y; Rochford G; Rigaud M; Essajee S; Pollack H; Krasinski K; Borkowsky aW
2001 Jul 1;33(1):E3-E7, Clinical infectious diseases
From 1997 through 1999, the prevalence of the zidovudine resistance mutation T215Y was 9.7% among pregnant women, and the human immunodeficiency virus type 1 (HIV-1) load in those with resistant virus was higher than that measured in women with wild-type HIV-1. All mutations were noted in women with zidovudine experience, which suggests that monotherapy may not be adequate prophylaxis for vertical transmission of HIV-1 infection in the current era
— id: 20631, year: 2001, vol: 33, page: E3, stat: Journal Article,

Early Changes in Quasispecies Repertoire in HIV-Infected Infants: Correlation with Disease Progression
Essajee SM; Pollack H; Rochford G; Oransky I; Krasinski K; Borkowsky W
2000 Dec;16(18):1949-1957, AIDS research & human retroviruses
The evolution of HIV-1 quasispecies in patients during the first year of life was investigated in 10 vertically infected infants, using heteroduplex analysis of the V3-V5 region of env. Four subjects, who showed little viral evolution during the period of the study, had rapid progression of disease and early loss of CD4(+) cells. The remaining six subjects, who were slow progressors, evolved new viral variants within 6 months, and in one case by 1 month of age. Of the four patients who were PCR positive at birth, one was infected with multiple HIV-1 variants. These results show that in HIV-infected children, multiple variants may initiate infection and early quasispecies diversification is associated with a favorable clinical outcome
— id: 14545, year: 2000, vol: 16, page: 1949, stat: Journal Article,

Pneumocystis carinii presenting as an intra-abdominal cystic mass in a child with Acquired Immunodeficiency Syndrome (AIDS)
Hagmann, S; Sitnitskaya, K; Pollack, H
2000 JUL ;31(1):251-251, Clinical infectious diseases
— id: 54484, year: 2000, vol: 31, page: 251, stat: Journal Article,

Why do cytotoxic T lymphocytes fail to eliminate hepatitis C virus? Lessons from studies using major histocompatibility complex class I peptide tetramers
Lechner, F; Sullivan, J; Spiegel, H; Nixon, DF; Ferrari, B; Davis, A; Borkowsky, B; Pollack, H; Barnes, E; Dusheiko, G; Klenerman, P
2000 AUG 29 ;355(1400):1085-1092, Philosophical transactions of the Royal Society of London. Series B. Biological sciences
Hepatitis C virus (HCV) infection is a major public health problem, affecting an estimated 3% of the world's population, and over 10% in some countries. Infection in most cases becomes persistent, and can lead to hepatic inflammation, fibrosis and liver failure. The T lymphocyte reponse, in particular that mediated by cytotoxic T lymphocytes (CTLs), is likely to be involved in determining the outcome of infection, although its overall role is not clear. The use of major histocompatibility complex (MHC) class I peptide tetrameric complexes (tetramers) to study antiviral CTL responses has revolutionized our approach tc, the study of human infection. We have used a panel of MHC class I tetramers to analyse immune responses in HCV-infected individuals at various stages of disease. We find that the CTL response against HCV is vigorous in its early phases but dwindles over time both in terms of lymphocyte number and function. A number of potential explanations for this 'CTL failure' are discussed
— id: 54521, year: 2000, vol: 355, page: 1085, stat: Journal Article,

Trends in mode of delivery (HIV-infected women, N. America (PACTG 367))
Read, JS; Tuomala, R; Shapiro, D; Samelson, R; Ciupak, G; McNamara, J; Burchett, S; Pollack, H
2000 JUL ;31(1):267-267, Clinical infectious diseases
— id: 54485, year: 2000, vol: 31, page: 267, stat: Journal Article,

The impact of early initiation of highly active antiretroviral therapy on the human immunodeficiency virus type 1-specific CD8 T cell response in children
Spiegel HM; Chandwani R; Sheehy ME; Dobroszycki J; Fennelly G; Wiznia A; Radding J; Rigaud M; Pollack H; Borkowsky W; Rosenberg M; Nixon DF
2000 Jul;182(1):88-95, Journal of infectious diseases
This cross-sectional study investigated the effect of early highly active antiretroviral therapy (HAART) on human immunodeficiency virus (HIV) type 1-specific CD8 T cell responses in children. HIV-1-specific CD8 T cell responses were quantified using an enzyme-linked immunospot assay to measure interferon-gamma-secreting cells. HIV-1-infected children were classified by time of HAART initiation prior to age 1 year or after age 2 years as early (n=24) or late (n=28) treated. The magnitude and breadth of the HIV-1-specific CD8 T cell response was significantly lower in children receiving early compared with late HAART treatment (P=.0007 and.0001, respectively). However, total CD8 T cell responses in the early HAART treatment group did not differ significantly from those of age-matched non-HAART-treated controls (n=30). Thus, the reduced magnitude and breadth of the HIV-1-specific CD8 T cell response in early HAART-treated children is due to their younger age
— id: 14547, year: 2000, vol: 182, page: 88, stat: Journal Article,

Human immunodeficiency virus type 1- and cytomegalovirus-specific cytotoxic T lymphocytes can persist at high frequency for prolonged periods in the absence of circulating peripheral CD4(+) T cells
Spiegel HM; Ogg GS; DeFalcon E; Sheehy ME; Monard S; Haslett PA; Gillespie G; Donahoe SM; Pollack H; Borkowsky W; McMichael AJ; Nixon DF
2000 Jan;74(2):1018-1022, Journal of virology
CD4(+) T cells are thought to be critical in the maintenance of virus-specific CD8(+) cytotoxic T-cell (CTL) responses. In human immunodeficiency virus type 1 (HIV-1) infection, a selective decline in HIV-1-specific CTL as the CD4(+) T-cell count decreases has been reported. Using HLA-peptide tetrameric complexes, we show the presence at high frequency of HIV-1- and cytomegalovirus-specific CD8(+) T cells when the peripheral CD4(+) T-cell count was low or zero in three HIV-1-infected patients. No direct virus-specific CD8(+)-mediated effector activity was seen in these subjects, suggesting antigen unresponsiveness, although tetramer-sorted cells could be expanded in vitro in the presence of interleukin-2 into responsive effector cells. Thus, virus-specific CD8(+) T cells can be maintained in the peripheral circulation at high frequency in the absence of circulating peripheral CD4(+) T cells, but these cells may lack direct effector activity. Strategies designed to overcome this antigen unresponsiveness may be of value in therapies for the treatment of AIDS
— id: 14549, year: 2000, vol: 74, page: 1018, stat: Journal Article,

Immunologic and virologic responses to HAART in severely immunocompromised HIV-1-infected children
Essajee SM; Kim M; Gonzalez C; Rigaud M; Kaul A; Chandwani S; Hoover W; Lawrence R; Spiegel H; Pollack H; Krasinski K; Borkowsky W
1999 Dec 24;13(18):2523-2532, AIDS
OBJECTIVE: To determine the long-term immunologic and virologic effects of highly active antiretroviral therapy (HAART) in children with AIDS. DESIGN: A prospective observational study. SETTING: Two pediatric HIV clinics. PARTICIPANTS: Twenty-five protease-inhibitor naive HIV-infected children (aged 2-18 years) with advanced disease (CD4 < or =6%). INTERVENTION: HAART (one protease inhibitor and one or more nucleoside analogs). Diphtheria and tetanus immunization in six patients after 18 months of therapy. MAIN OUTCOME MEASURES: Changes in percentage of CD4 cells and plasma HIV-1 RNA levels; post-treatment assays of lymphoproliferative responses to recall antigens; CD4 cell memory phenotype. RESULTS: Median duration of follow-up was 18.8 months (range, 7.5-28 months). At baseline the CD4 cell percentage was 2% (range, 0-6%), this increased significantly to 16% (range, 3-48%) above baseline at 12 months (P = 0.002). The mean maximum CD4 cell increase was 20.7% (range 4-48%) which corresponds to 657x10(6) cells/l (range, 30-2240x10(6) cells/l) above baseline. By contrast, the median viral load was not significantly lower at 12 months than at baseline (P = 0.34), and only 25% of the patients had sustained undetectable viral load. Of the reconstituted CD4 cells 70% were naive, and none of the subjects had lymphoproliferative responses to tetanus and diphtheria although 40% did develop responses to Candida, an environmental antigen. A single immunization with diphtheria and tetanus toxoid produced lymphoproliferative responses to tetanus in three out of six patients. CONCLUSIONS: HAART was associated with sustained increases in CD4 cell counts, despite a high incidence of 'virologic failure'. CD4 counts and the proportion of naive cells were higher than have been reported in adults, which may be a reflection of greater thymic activity in children. Memory cell clones for antigens encountered in the past which are not prevalent before therapy could not be expanded without additional antigenic exposure
— id: 8585, year: 1999, vol: 13, page: 2523, stat: Journal Article,

A polymorphism in the regulatory region of the CC-chemokine receptor 5 gene influences perinatal transmission of human immunodeficiency virus type 1 to African-American infants
Kostrikis LG; Neumann AU; Thomson B; Korber BT; McHardy P; Karanicolas R; Deutsch L; Huang Y; Lew JF; McIntosh K; Pollack H; Borkowsky W; Spiegel HM; Palumbo P; Oleske J; Bardeguez A; Luzuriaga K; Sullivan J; Wolinsky SM; Koup RA; Ho DD; Moore JP
1999 Dec;73(12):10264-10271, Journal of virology
There are natural mutations in the coding and noncoding regions of the human immunodeficiency virus type 1 (HIV-1) CC-chemokine coreceptor 5 (CCR5) and in the related CCR2 protein (the CCR2-64I mutation). Individuals homozygous for the CCR5-Delta32 allele, which prevents CCR5 expression, strongly resist HIV-1 infection. Several genetic polymorphisms have been identified within the CCR5 5' regulatory region, some of which influence the rate of disease progression in adult AIDS study cohorts. We genotyped 1,442 infants (1,235 uninfected and 207 HIV-1 infected) for five CCR5 and CCR2 polymorphisms: CCR5-59353-T/C, CCR5-59356-C/T CCR5-59402-A/G, CCR5-Delta32, and CCR2-64I. The clinical significance of each genotype was assessed by measuring whether it influenced the rate of perinatal HIV-1 transmission among 667 AZT-untreated mother-infant pairs (554 uninfected and 113 HIV-1 infected). We found that the mutant CCR5-59356-T allele is relatively common in African-Americans (20.6% allele frequency among 552 infants) and rare in Caucasians and Hispanics (3.4 and 5.6% of 174 and 458 infants, respectively; P < 0.001). There were 38 infants homozygous for CCR5-59356-T, of whom 35 were African-Americans. Among the African-American infants in the AZT-untreated group, there was a highly significant increase in HIV-1 transmission to infants with two mutant CCR5-59356-T alleles (47.6% of 21), compared to those with no or one mutant allele (13.4 to 14.1% of 187 and 71, respectively; P < 0.001). The increased relative risk was 5.9 (95% confidence interval, 2.3 to 15.3; P < 0.001). The frequency of the CCR5-59356-T mutation varies between population groups in the United States, a low frequency occurring in Caucasians and a higher frequency occurring in African-Americans. Homozygosity for CCR5-59356-T is strongly associated with an increased rate of perinatal HIV-1 transmission
— id: 14550, year: 1999, vol: 73, page: 10264, stat: Journal Article,

Changes in frequency of HIV-1-specific cytotoxic T cell precursors and circulating effectors after combination antiretroviral therapy in children
Spiegel HM; DeFalcon E; Ogg GS; Larsson M; Beadle TJ; Tao P; McMichael AJ; Bhardwaj N; O'Callaghan C; Cox WI; Krasinski K; Pollack H; Borkowsky W; Nixon DF
1999 Aug;180(2):359-368, Journal of infectious diseases
Combination antiretroviral therapy has had a major role in reducing human immunodeficiency virus type 1 (HIV-1) plasma viral loads in HIV-1-infected adults but a variable effect in infants, in whom complete viral suppression appears to be less readily achieved. In adults, after the reduction in plasma viremia, there is a decrease in the numbers of circulating cytotoxic T cell (CTL) effectors and precursors in the majority of patients. This longitudinal study assessed the effect of combination drug therapy on the frequency of HIV-1-specific CTL responses in 8 HIV-1-infected children. Following treatment, the frequency of HIV-1-specific CTL responses initially increased, especially in children with incomplete viral suppression but with increasing CD4+ cell counts. In children with complete viral suppression, the frequency of HIV-1-specific CTL responses decreased, suggesting that viral replication is required to maintain CTL responses in the systemic circulation
— id: 14552, year: 1999, vol: 180, page: 359, stat: Journal Article,

Expression patterns of the HIV type 1 coreceptors CCR5 and CXCR4 on CD4+ T cells and monocytes from cord and adult blood
Mo H; Monard S; Pollack H; Ip J; Rochford G; Wu L; Hoxie J; Borkowsky W; Ho DD; Moore JP
1998 May 1;14(7):607-617, AIDS research & human retroviruses
We have measured the surface expression of the HIV-1 coreceptors CCR5 and CXCR4 on CD4+ T cells and monocytes from cord and adult blood. The expression of CCR5 was largely restricted to the memory (CD45RAlow) subset, whereas CXCR4 was expressed on both memory and naive (CD45RAhigh) T cells. The paucity of memory CD4+ T cells in cord blood means that CCR5-positive cells are relatively uncommon, so the overall extent of CCR5 expression was reduced in cord blood, compared with adult blood. IL-2 activation of CD4+ T cells from both cord and adult bloods caused a substantial increase in CCR5 expression, but moderately decreased CXCR4 expression. PHA stimulation increased CCR5 expression slightly, but only on naive cells. Monocytes expressed both CCR5 and CXCR4 at levels that differed little between cord and adult blood
— id: 14555, year: 1998, vol: 14, page: 607, stat: Journal Article,

Increased transmission of vertical hepatitis C virus (HCV) infection to human immunodeficiency virus (HIV)-infected infants of HIV- and HCV-coinfected women
Papaevangelou V; Pollack H; Rochford G; Kokka R; Hou Z; Chernoff D; Hanna B; Krasinski K; Borkowsky W
1998 Oct;178(4):1047-1052, Journal of infectious diseases
The transmission of perinatal hepatitis C virus (HCV) infection was studied retrospectively in 62 infants born to 54 HCV- and human immunodeficiency virus (HIV)-coinfected women enrolled in a prospective natural history study of HIV transmission. Infant HCV infection was assessed by nested RNA polymerase chain reaction. The overall rate of vertical HCV transmission was 16.4% (9/62). Most HCV-infected children did not develop antibodies to HCV. The rate of HCV infection was higher among HIV-infected infants (40%) than among HIV-uninfected infants (7.5%; odds ratio, 8.2; P = .009). This difference in transmission was not related to differences in maternal HCV load, as measured by branched DNA assay, or mode of delivery. Why HIV-infected infants of HCV- and HIV-coinfected women have significantly higher rates of perinatal HCV transmission remains to be elucidated. The rate of HCV transmission in HIV-uninfected infants of HCV- and HIV-coinfected women is similar to that reported for infants born to HIV-seronegative mothers
— id: 7730, year: 1998, vol: 178, page: 1047, stat: Journal Article,

Impaired early growth of infants perinatally infected with human immunodeficiency virus: correlation with viral load
Pollack H; Glasberg H; Lee E; Nirenberg A; David R; Krasinski K; Borkowsky W; Oberfield S
1997 Jun;130(6):915-922, Journal of pediatrics
OBJECTIVE: To evaluate the effect of viral load on the early growth of infants infected with human immunodeficiency virus (HIV). METHODS: Plasma concentrations of p24-antigen and HIV ribonucleic acid were measured retrospectively and correlated with growth parameters for the first 18 months of life in a cohort of 47 term infants born to HIV-infected mothers prospectively enrolled in a study of perinatal HIV transmission. Comparisons of the mean weight and length of the 18 HIV-infected and 29 uninfected infants for each interval and across intervals were made. Viral load was correlated with standard deviation scores. Infants were stratified by high and low viral load during the first 6 months of life. RESULTS: At birth, no difference in weight and length was observed between HIV-infected and uninfected infants. Between birth and 6 months of age, the infected infants grew less rapidly than the uninfected infants, a finding temporally associated with an exponential increase in HIV viremia. The linear growth of infected infants remained consistently less than that of the uninfected infants after 6 months of life, although the differences were no longer statistically significant and tended to decrease with age in parallel with declines in viral load. The median plasma concentration of HIV ribonucleic acid was significantly higher at 3, 6, 12, and 18 months in infected infants in whom growth failure developed. Infants who had a high viral load in the first 6 months of life were significantly more likely to have severe growth failure. Though the mean SD for weight of the infected infants was always less than that of the uninfected infants, the differences were small and not significant. CONCLUSIONS: Our results confirm the observation that stunting is an early frequent finding in perinatal HIV infection. The deleterious effect of HIV on linear growth appears to be correlated with the level of postnatal HIV viremia, although the exact mechanism of this association remains to be elucidated
— id: 7235, year: 1997, vol: 130, page: 915, stat: Journal Article,

CD8+ T-cell-mediated suppression of HIV replication in the first year of life: association with lower viral load and favorable early survival
Pollack H; Zhan MX; Safrit JT; Chen SH; Rochford G; Tao PZ; Koup R; Krasinski K; Borkowsky W
1997 Jan;11(1):F9-13, AIDS
OBJECTIVE AND DESIGN: To study the role and development of non-cytotoxic CD8+ T-cell-mediated suppression of HIV replication in early perinatal HIV infection in a prospective study of vertically infected infants. CD8 T-cell-mediated HIV suppression was measured several times during the first year of life and correlated with viral load, cytotoxic T-cell (CTL) activity, in vitro antibody production (IVAP) and clinical outcome. METHODS: CD8+ T-cell-mediated HIV suppression was measured by comparing the amount of p24 antigen produced by endogenously infected lymphocytes with cultures of the same number of autologous CD4+ T cells from which CD8+ cells were removed immunomagnetically. CD8 viral suppressive activity (VSA) was defined as a > or = 50% reduction in p24 antigen in the cultures containing CD8+ cells. RESULTS: CD8+ T-cell-mediated HIV VSA was detected in 11/16 infants in the first year of life, including six/nine infants studied before 6 months and as early as 3 weeks of age. Infants who demonstrated CD8 VSA had a lower early peak and 6-month 'setpoint' plasma HIV RNA concentration than infants who lacked CD8 VSA [1.51 versus 4.94 and 0.094 versus 0.639 x 10(6) copies/ml, respectively, and higher CD4 percentage at 1 year of age. Survival of infants lacking CD8 VSA (four/six were rapid progressors) was shorter than for infants who demonstrated CD8 VSA (none out of 10 were rapid progressors). CD8 VSA was present before CTL and before or at the same time as IVAP in two of two and 11 of 14 infants studied, respectively. CONCLUSIONS: CD8+ T-cell-mediated VSA can be demonstrated in a large proportion of HIV-infected infants early in the course of infection. This non-cytolytic HIV-suppressive immune response appears to play an important protective role in the early control of perinatal HIV infection at a time when other immune responses are either absent or deficient
— id: 12412, year: 1997, vol: 11, page: F9, stat: Journal Article,

Comparison of PCR and standard cytological staining for detection of Pneumocystis carinii from respiratory specimens from patients with or at high risk for infection by human immunodeficiency virus (vol 33, pg 3005, 1995)
Leibovitz, E; Pollack, H; Moore, T; Papellas, J; Gallo, L; Krasinski, K; Borkowsky, W
1996 JAN ;34(1):236-236, Journal of clinical microbiology
— id: 53110, year: 1996, vol: 34, page: 236, stat: Journal Article,

The amount of early p24 antigenemia and not the time of first detection of virus predicts the clinical outcome of infants vertically infected with human immunodeficiency virus
Papaevangelou V; Pollack H; Riguad M; Arlievsky N; Lu ML; Rochford G; Krasinski K; Borkowsky W
1996 Mar;173(3):574-578, Journal of infectious diseases
Twenty-three children vertically infected with human immunodeficiency virus type 1 (HIV-1) were studied for viremia during the first days of life. Nine had HIV-1 infection within the first week (early); 14 had HIV-1 first detected by day 11-90 (late). The groups had similar incidence and time of onset of symptomatic HIV-1 infection and survival. CD4 T cell percentages, rates of CD4 T cell attrition, quantitative cell-associated viremia, and p24 antigen concentrations were comparable. Children with peak antigen concentrations >100 pg/mL during the first 6 months (5 early, 6 late) fared worse than those with lower p24 levels. Thus, HIV-1-infected infants with detectable virus in the first few days of life do not have a worse prognosis than infants whose virus is detectable only later. Elevated p24 antigenemia during the first 6 months of life correlates strongly with poor clinical outcome and is independent of the time virus was first detected
— id: 6944, year: 1996, vol: 173, page: 574, stat: Journal Article,

Neurodevelopment, growth, and viral load in HIV-infected infants
Pollack H; Kuchuk A; Cowan L; Hacimamutoglu S; Glasberg H; David R; Krasinski K; Borkowsky W; Oberfield S
1996 Sep;10(3):298-312, Brain, behavior & immunity
The relation of HIV-1 infection to infant growth and neurodevelopment was studied prospectively in a cohort of 65 infants born to women at risk for HIV infection. No differences were observed at birth between infected infants (INF) and uninfected infants (SR) of HIV-infected women, and infants of uninfected women (SN) with similar socioeconomic background and exposure to drugs. However, postnatal linear growth and cognitive-motor development of INF infants were impaired when compared to SR and SN infants. Declines in linear growth were observed within the first 6 months of life, whereas delays in neurodevelopment were first appreciated at 12 months. In INF infants, decreased linear growth was positively correlated with developmental delay. Moreover, growth and development were both correlated with HIV viral load. INF infants with high plasma HIV RNA copies (> 5 x 10(5)/ ml) at 6 months of life were more likely to exhibit severe growth and developmental delay than infants with a lower viral burden. The implications of these findings with respect to the mechanism of action of HIV-related growth and neurodevelopmental impairments are discussed
— id: 12544, year: 1996, vol: 10, page: 298, stat: Journal Article,

Recurrent pneumococcal bacteremia in HIV-1 infected children
Spiegel, H; Kaul, A; Chandwani, S; Desiderio, D; Lawrence, R; Pollack, H; Krasinski, K; Borkowsky, W
1996 OCT ;23(4):118-118, Clinical infectious diseases
— id: 52755, year: 1996, vol: 23, page: 118, stat: Journal Article,

Shortened survival in infants vertically infected with human immunodeficiency virus with elevated p24 antigenemia
Arlievsky NZ; Pollack H; Rigaud M; Kaul A; Krasinski K; Borkowsky W
1995 Oct;127(4):538-543, Journal of pediatrics
OBJECTIVE: To determine whether the amount of p24 antigenemia in the first 6 months of life is a predictor of survival in children infected vertically with human immunodeficiency virus type 1. METHODS: A retrospective study of vertically infected infants and children who were followed prospectively from early infancy and who had quantitation of plasma p24 antigen concentration in the first 6 months of life. Infants were first stratified by duration of survival as infants who died before 2 years of age (short-term survivors) and infants who survived to 2 years of age (intermediate-term survivors). The median p24 antigen concentration and the proportion of infants in each group with high concentrations of antigen were compared. Analyses with and excluding all p24 determinations made after the use of antiretroviral agents were compared Kaplan-Meier product limit analysis was used to compare survival in infants with low and high antigenemia during the first 6 months of life. RESULTS: The median p24 antigen concentration in 15 short-term survivors was 228 pg/ml, compared with 14 pg/ml in 26 intermediate-term survivors (p < 0.05). The proportion of children with > 100 pg/ml of p24 was higher in short-term than in intermediate-term survivors (p = 0.01). Survival to 2 years of age in infants in whom all p24 antigen values during the first 6 months of life were 100 pg/ml or less was 91%, in comparison with 39% in infants with values greater than 100 pg/ml (p = 0.0017). CONCLUSIONS: Elevated p24 antigenemia in the first 6 months of life is associated with shorter survival and may be a useful predictor of outcome
— id: 6802, year: 1995, vol: 127, page: 538, stat: Journal Article,

Comparison of PCR and standard cytological staining for detection of Pneumocystis carinii from respiratory specimens from patients with or at high risk for infection by human immunodeficiency virus [published erratum appears in J Clin Microbiol 1996 Jan;34(1):236]
Leibovitz E; Pollack H; Moore T; Papellas J; Gallo L; Krasinski K; Borkowsky W
1995 Nov;33(11):3004-3007, Journal of clinical microbiology
The detection of Pneumocystis carinii DNA by PCR was compared with routine cytologic staining techniques (CYT). A total of 284 clinical respiratory specimens, including 137 bronchoalveolar lavage (BAL), 63 bronchoalveolar washing, 63 sputum, and 21 induced sputum samples, obtained from patients with or at high risk for human immunodeficiency virus infection were evaluated. Eighty specimens were positive by PCR, and 69 were positive by CYT. PCR was able to detect P. carinii in more bronchoalveolar washing specimens (15 versus 11) and in comparable BAL specimens (53 versus 54) compared with CYT. PCR was particularly more sensitive than CYT in detecting P. carinii in expectorated sputum (12 versus 4 samples). Of the 19 patients whose respiratory specimens were positive for P. carinii by PCR but negative by CYT, 5 had P. carinii pneumonia (PCP) confirmed by subsequent BAL and transbronchial or mediastinal lymph node biopsy and 9 had a clinical course highly suggestive of acute PCP. Eleven (58%) of the 19 patients with discordant PCR and CYT results had received prior anti-PCP prophylaxis. In this clinical setting in particular and in the evaluation of sputum specimens, the ability of PCR to detect a low parasitic load suggests that this technique may become an important additional tool, along with current cytological methods, for the detection of P. carinii
— id: 7195, year: 1995, vol: 33, page: 3004, stat: Journal Article,

Polymerase chain reaction is more sensitive than standard cytologic stains in detecting Pneumocystis carinii in bronchoalveolar lavages from human immunodeficiency virus type 1-infected infants and children with pneumonia
Leibovitz E; Pollack H; Rigaud M; Kaul A; Persaud D; Gallo L; Papellas J; Krasinski K; Borkowsky W
1995 Aug;14(8):714-716, Pediatric infectious disease journal
— id: 7910, year: 1995, vol: 14, page: 714, stat: Journal Article,

CORRELATION BETWEEN THE MAGNITUDE OF VIRAL LOAD IN EARLY INFANCY AND SURVIVAL AMONG PERINATALLY HIV-INFECTED CHILDREN
POLLACK, H; ARLIEVSKY, N; RIGAUD, M; KAUL, A; KRASINSKI, K; BORKOWSKY, W
1995 APR 2 ;54(3):242-242, Journal of cellular biochemistry
— id: 87326, year: 1995, vol: 54, page: 242, stat: Journal Article,

Subacute pneumococcal pericarditis in a patient who did not develop tamponade
Arlievsky N; Rigaud M; Pollack H; Borkowsky W; Krasinski K
1994 Dec;19(6):1163-1163, Clinical infectious diseases
— id: 14559, year: 1994, vol: 19, page: 1163, stat: Journal Article,

Correlation of perinatal transmission of human immunodeficiency virus type 1 with maternal viremia and lymphocyte phenotypes
Borkowsky W; Krasinski K; Cao Y; Ho D; Pollack H; Moore T; Chen SH; Allen M; Tao PT
1994 Sep;125(3):345-351, Journal of pediatrics
OBJECTIVE: To determine whether maternal transmission of human immunodeficiency virus (HIV) is correlated with increased quantities of HIV, decreased frequencies of CD4+ T cells, or increased levels of CD8+ T cells in the transmitting mother. METHODS: Peripheral blood obtained from HIV-infected women at different times during pregnancy was used to measure quantitative cell-associated HIV-1 and CD3+CD4+ and CD3+CD8+ proportions; the plasma was used to perform measurements of quantitative viremia by culture and subsequently to measure quantitative HIV-1 ribonucleic acid levels. These measurements were analyzed with respect to their association with HIV transmission to the baby, which occurred in one fourth of the cases. The children were also studied to determine whether HIV-1 was detected near birth or not until 1 to 8 weeks of life. RESULTS: Increased clonal frequencies of HIV-1-infected peripheral blood mononuclear cells were found in mothers of infected children; fivefold fewer cells were required for a positive culture result (median cell numbers of 10(4.5) vs 10(5.2); p = 0.008). Higher frequencies of infected cells were seen in mothers of babies with evidence of infection at birth than in mothers of infected babies without evidence of infection at birth (p < 0.05). Plasma viremia was measured in 10% of cultures without regard to whether the mothers transmitted virus to their babies. Increased levels of ribonucleic acid as detected by the branched-chain DNA method were measurable more often (45% vs 17%) in the mothers of infected children than in mothers of uninfected children. Proportions of CD4+ and CD8+ T cells were indistinguishable in these two groups of women. CONCLUSIONS: Increased viremia was present in mothers who transmitted HIV to their offspring. This variable could be used to select women at highest risk of transmitting HIV to their offspring for treatment to decrease the HIV burden five-fold
— id: 8459, year: 1994, vol: 125, page: 345, stat: Journal Article,

Streptococcus pneumoniae in human immunodeficiency virus type 1-infected children
Gesner M; Desiderio D; Kim M; Kaul A; Lawrence R; Chandwani S; Pollack H; Rigaud M; Krasinski K; Borkowsky W
1994 Aug;13(8):697-703, Pediatric infectious disease journal
The purpose of this study was to characterize systemic Streptococcus pneumoniae disease in human immunodeficiency virus type 1 (HIV-1)-infected children. All cases of bacteremia and meningitis caused by S. pneumoniae among children less than 18 years old were collected by review of the Microbiology Laboratory records at the Bellevue Hospital Center during the period August 1, 1978, through July 31, 1993. There were 31 bouts of systemic S. pneumoniae disease in 19 of 235 HIV-1-infected children cared for by the Pediatric Infectious Disease staff and 116 bouts in 113 children not known to be HIV-1-infected. Four of the 19 HIV-1-infected children had multiple episodes of S. pneumoniae bacteremia as compared with 3 of 113 in the general population (P = 0.008). The frequency of serotypes and distribution of infections by season of the year did not differ between the 2 groups. The median ages at the time of the S. pneumoniae infection were 1.8 and 1.1 years for the HIV-1-infected children and the general population of children, respectively, when those children with multiple episodes were included for their initial episode only (P = 0.06). In the HIV-1-infected patients, 10 episodes were associated with pneumonia, 5 with pneumonia and otitis media, 5 with otitis media only, 1 with pneumonia and meningitis, 1 with meningitis only and 1 with periorbital cellulitis; 5 had no apparent focus of infection. One episode of pneumonia was complicated by lung abscess and there were 2 deaths. Most HIV-1-infected patients recovered without significant sequelae, and the clinical course of their systemic infections did not appear to be markedly different than that of healthy children
— id: 12935, year: 1994, vol: 13, page: 697, stat: Journal Article,

HIV-1 infected children with severe immunodeficiency: survival and prognostic factors
Papaevangelou V; Pollack H; Kaul A; Lawrence R; Krasinski K; Borkowsky W
1994 Oct 4-7;:35-35, Program & abstracts (Interscience Conference on Antimicrobial Agents & Chemotherapy)
Objective: To study the survival and identify prognostic laboratory indicators for HIV-1 infected children with severe immunodeficiency (CD4 less than 15%). Methods: Kaplan-Meier product-limit analysis, from the time of severe immunodeficiency (i.e. presentation with CD4 less than 15% or persistent levels of CD4 less than 15%), was performed on HIV-1 infected children. Plasma p24 antigen and serial hemoglobin concentrations were reviewed as possible prognostic indicators of survival. Results: (Table: see text.) The presence of plasma p24 antigen at presentation did not appear to affect survival in children with CD4 between 10-15%, however the absence of detectable plasma p24 antigen was associated with increased survival in those with CD4 of less than 10% at presentation (50% survival 4.5y and 3.4y for children with CD4 5-9% and 0-4% respectively). A 15% reduction in serum hemoglobin concentration, was associated with decreased 50% survival only in children with CD4 less than 10% (6.2y vs 2.3y). Conclusions: Children with 9 greater than CD4% less than 15% are considered to be severely immunodeficient by the CDC, yet their 50% survival is significantly better than children who present with CD4 less than 10%. The absence of detectable p24 antigenemia at presentation appeared to be associated with improved survival only in children with CD4 T cells less than 10%, whereas a 15% decrease in serum hemoglobin concentration was associated with lower survival only in those with greater than 10% CD4 T cells
— id: 5994, year: 1994, vol: , page: 35, stat: Journal Article,

Effects of antiviral therapy on the production of anti-human immunodeficiency virus-specific immunoglobulin in infants and children
Pollack H; Zhan MX; Moore T; Tao PZ; Krasinski K; Borkowsky W
1994 Oct;170(4):1003-1006, Journal of infectious diseases
The effect of zidovudine therapy on human immunodeficiency virus (HIV)-specific antibody production was studied in 64 HIV-1-infected infants and children > 6 months old. HIV-specific in vitro antibody production (IVAP) was measured in cultures of peripheral blood mononuclear cells (PBMC). IVAP decreased in 85% of children after zidovudine was initiated (mean decline, 1 log within 2 months). Effects were seen as early as 1 week after starting zidovudine. No change in IVAP was seen in children not treated. In comparison, plasma core (p24) antigen levels declined and CD4+ lymphocytes increased in only 42% and 52%, respectively, of treated subjects. Thus, the production of antibody to HIV-1 decreases rapidly after the initiation of antiretroviral therapy. This response to therapy may provide a simple and sensitive method of monitoring antiretroviral therapy
— id: 6716, year: 1994, vol: 170, page: 1003, stat: Journal Article,

CD8-MEDIATED SUPPRESSION OF AUTOLOGOUS HIV-1 REPLICATION IN A 5 WEEK OLD HIV-1-INFECTED INFANT
POLLACK, H; ZHAN, MX; PAPAEVANGELOU, V; CHEN, SH; TAO, P; KRASINSKI, K; BORKOWSKY, W
1994 APR ;35(4):A192-A192, Pediatric research
— id: 52466, year: 1994, vol: 35, page: A192, stat: Journal Article,

Efficacy of primary chemoprophylaxis against Pneumocystis carinii pneumonia during the first year of life in infants infected with human immunodeficiency virus type 1
Rigaud M; Pollack H; Leibovitz E; Kim M; Persaud D; Kaul A; Lawrence R; John DD; Borkowsky W; Krasinski K
1994 Sep;125(3):476-480, Journal of pediatrics
To evaluate the efficacy of primary chemoprophylaxis in preventing Pneumocystis carinii pneumonia (PCP) in infants with perinatal human immunodeficiency virus-1 infection during the first year of life, we conducted a retrospective chart review of infants with human immunodeficiency virus-1 infection born at New York University Medical Center-Bellevue Hospital Center, in New York. Between March 1989 and March 1993, 24 infants received primary chemoprophylaxis with trimethoprim-sulfamethoxazole in the first year of life and 24 infants did not receive primary prophylaxis. The CD4+ T-lymphocyte counts in the two groups did not differ during the first year of life. The median age at the time of initiation of prophylaxis was 3 months, and the average duration of prophylaxis was 5.5 months. Among the infants who had not received prophylaxis, five cases of PCP were diagnosed at a median age of 5 months; in contrast, no cases of PCP were observed in the infants receiving prophylaxis (log-rank test, p = 0.017). The probability of surviving after 1 year of age was 92% for the children who received prophylaxis and 74% for those who did not (log-rank test, p = 0.035). These data indicate that chemoprophylaxis is highly effective in preventing primary PCP and improving survival time in infants with human immunodeficiency virus-1 infection
— id: 12908, year: 1994, vol: 125, page: 476, stat: Journal Article,

HIV-1 viremia in the first week of life in perinatal infection: effect on CD4% and survival
Zarudsky N; Rigaud M; Pollack H; Kaul A; Kim M; Krasinski K; Borkowsky W
1994 Oct 4-7;:33-33, Program & abstracts (Interscience Conference on Antimicrobial Agents & Chemotherapy)
Objective: To compare survival and CD4+ T cell % (CD4%) in infants with early versus late HIV viremia. Methods: HIV viremia was measured by HIV culture. PCR or P24 ag assay of peripheral blood. Three groups were identified: infants testing positive within the first week of life (X), infants testing negative in the first week and positive within two months (Y), infants tested after the first week but positive within two months (Z). Initial CD4% for all infants in the three groups were compared using the t test. CD4% attrition in the three groups was compared using linear regressions of the last CD4% measured in each infant. Survival times were evaluated by Kaplan-Meier product-limit analyses and compared by log-rank tests. Results: There were nine infants in group X, 12 in group Y, and 20 in group Z. There were no differences in CD4% at birth among these groups. Decline of CD4% in groups X, Y and Z was -0.30, -0.18 and -3.0% per month respectively. These were not significantly different. Survival in the three groups (X vs Y, log-rank p=0.24; Y vs Z, log-rank p=0.42; X vs Z, log-rank p=0.65) was not significantly different. Conclusions: The data suggest that early HIV-1 viremia in perinatal infection is not associated with more rapid decline of CD4% and decreased survival in this small sample. Further studies must be done to determine whether early HIV viremia in perinatal HIV-1 infection can serve as a prognostic indicator
— id: 5997, year: 1994, vol: , page: 33, stat: Journal Article,

Ontogeny of anti-human immunodeficiency virus (HIV) antibody production in HIV-1-infected infants
Pollack H; Zhan MX; Ilmet-Moore T; Ajuang-Simbiri K; Krasinski K; Borkowsky W
1993 Mar 15;90(6):2340-2344, Proceedings of the National Academy of Sciences of the United States of America
The early serologic response of infants to infection with human immunodeficiency virus type 1 (HIV-1) is normally obscured by the presence of transplacentally acquired maternal HIV antibody. By measuring HIV antibody produced in vitro by lymphocytes isolated from peripheral blood of infants and children of HIV-1-infected mothers, we have been able to study the natural acquisition of humoral immunity to perinatal HIV-1 infection. One hundred ninety-seven infants of HIV-1-infected women were studied prospectively and longitudinally from birth. In the neonatal period, infected infants produced only small amounts of HIV-specific IgG antibodies to a restricted number of antigens. The amount of immunoglobulin to HIV-1 and the number of HIV-1 antigens recognized increased with age. After 6 months of life 85% of infected infants made detectable antibody to two or more viral proteins. Antibody to gp160 appeared first and was the most frequently found at all ages, followed by antibody to the envelope proteins gp120 and gp41. The amount of HIV antibody produced correlated positively with the percentage of CD4+ T lymphocytes in peripheral blood. This assay provides a method of studying the immunogenicity of vaccines against HIV-1 in HIV-1-infected infants and of assessing the effect of early therapeutic interventions on the humoral response to HIV-1
— id: 13214, year: 1993, vol: 90, page: 2340, stat: Journal Article,

A novel detection assay for the early diagnosis of HIV-1 infected infants
Pollack H; Zhan MX; Ilmet-Moore T; Tao P; Krasinski K; Borkowsky W
1993 Jun;6(6):582-586, Journal of acquired immune deficiency syndrome
This investigation compares the results of a new method of diagnosing HIV-1 infection in infants < 6 months of age with currently employed techniques including cocultivation, the polymerase chain reaction (PCR), serum p24 antigen, and in vitro antibody production (IVAP) measurements. The new method, called in vitro antigen (IVAG), measures p24 antigen released into culture supernatants of peripheral blood mononuclear cells that are incubated with Epstein-Barr virus (EBV). No activated donor lymphocytes or interleukin 2 (IL-2) are added to the culture. Using this technique, HIV-1 infection was detected in 15 of 17 HIV-1-infected infants < 2 months of age, including 3 of 7 infants tested at birth, and 15 of 15 HIV-1-infected infants between 2 and 6 months of age. None of 83 determinations of 15 uninfected infants were positive. These results were found to be comparable to results obtained by the traditional cocultivation technique and the polymerase chain reaction. Because of its simplicity and reduced cost, this sensitive and specific assay could be a valuable addition to the current methods of diagnosis of HIV-1 infection in young infants
— id: 13146, year: 1993, vol: 6, page: 582, stat: Journal Article,

Early diagnosis of human immunodeficiency virus infection in children less than 6 months of age: comparison of polymerase chain reaction, culture, and plasma antigen capture techniques
Borkowsky W; Krasinski K; Pollack H; Hoover W; Kaul A; Ilmet-Moore T
1992 Sep;166(3):616-619, Journal of infectious diseases
Three techniques were evaluated for their ability to detect human immunodeficiency virus (HIV) in infants from birth to 6 months of age. Polymerase chain reaction (PCR) and HIV cocultivation were of comparable sensitivity, detecting 90% of all positive specimens. Both techniques found positive results in approximately 5% of samples from seroreverting children. Both assays detected HIV in only half of infected newborns, suggesting that this fraction of children was infected during gestation. Plasma p24 antigen was detected in three-fourths of all samples tested but in only half of infected children during the first 2 months of life and 88% of samples from children during the next 4 months. The specificity of p24 antigen detection was 100%
— id: 13452, year: 1992, vol: 166, page: 616, stat: Journal Article,

Cell-mediated and humoral immune responses in children infected with human immunodeficiency virus during the first four years of life
Borkowsky W; Rigaud M; Krasinski K; Moore T; Lawrence R; Pollack H
1992 Mar;120(3):371-375, Journal of pediatrics
OBJECTIVES: To determine whether cell-mediated and humoral immune responses to recall antigens develop in children infected with the human immunodeficiency virus (HIV) and, if so, whether these responses are retained. METHODS: Children infected with HIV and uninfected children born to mothers infected with HIV were compared with respect to lymphoproliferative responses to recall antigens and protective levels of antibody to bacterial toxoids during the first 4 years of life. RESULTS: Children infected with HIV who were enrolled in a prospective study of the natural history of the infection were relatively normal (1) in their lymphoproliferative responses to diphtheria toxoid, tetanus toxoid, and Candida, and (2) in their ability to make protective diphtheria and tetanus antitoxins during the first 2 years of life. During the next 2 years, attrition was noted in both lymphoproliferative and humoral responses. Attrition in response was not necessarily correlated with declining numbers of helper T cells. CONCLUSIONS: These results suggest that both cellular and humoral immune responses develop early in life in most children infected with HIV, while they remain relatively well both clinically and immunologically. Previously reported severe immune deficits in these children were probably attributable to advanced clinical disease when they were first studied
— id: 13680, year: 1992, vol: 120, page: 371, stat: Journal Article,

PATHOLOGY OF THE PLACENTA IN MEASLES
CHANDWANI, S; NAGARAJ, A; KAUL, A; NUOVO, G; POLLACK, H; DEMOPOULOS, R; GRECO, MA
1992 ;66(Suppl 1):P2-P2, Laboratory investigation
— id: 52110, year: 1992, vol: 66, page: P2, stat: Journal Article,

Delayed recognition of human immunodeficiency virus infection in preadolescent children
Persaud D; Chandwani S; Rigaud M; Leibovitz E; Kaul A; Lawrence R; Pollack H; DiJohn D; Krasinski K; Borkowsky W
1992 Nov;90(5):688-691, Pediatrics
Thirty-two (18%) of 181 children cared for at our institution who were infected with the human immunodeficiency virus type 1 (HIV-1) were first seen, and HIV was diagnosed, when they were 4 years of age and older. Initial complaints or diagnoses for these children included the following: hematologic disorders (5) (3 idiopathic thrombocytopenic purpura, 1 neutropenia, 1 anemia); recurrent bacterial infections (10); Pneumocystis carinii pneumonia (3); developmental delay (1); skin disorders (2) (1 genital wart, 1 chronic zoster); weight loss (3); malignancy (1); and nephropathy (1). Eight children were referred for evaluation because of maternal HIV-1 infection. The risk factors for HIV-1 infection included maternal/perinatal exposure (22), perinatal blood transfusion (6), blood transfusion during infancy (2), and sexual abuse (2). Ten (31%) of the 32 children have subsequently died. The longest survival from perinatal infection was 12 years. HIV-1 infection in children can result in a prolonged clinical latency and can masquerade as other pathologic conditions. The absence of clinical symptoms in older children at risk for HIV-1 infection should not deter HIV testing
— id: 13381, year: 1992, vol: 90, page: 688, stat: Journal Article,

Thrombocytopenia in children infected with human immunodeficiency virus: long-term follow-up and therapeutic considerations
Rigaud M; Leibovitz E; Quee CS; Kaul A; Nardi M; Pollack H; Lawrence R; DiJohn D; Krasinski K; Karpatkin M; et al
1992 ;5(5):450-455, Journal of acquired immune deficiency syndrome
Among 180 children infected with human immunodeficiency virus (HIV-1), 14 (8%) developed thrombocytopenia during the course of the disease and have been followed for an average period of 18.8 months. Eight of 14 patients had clinical signs of bleeding. Increased levels of anti-platelet IgG antibodies were detected in 86% of patients tested and did not correlate with severity of disease. Eight patients were treated initially with intravenous immunoglobulins (IVIG) and responded with a transient increase in the platelet count of at least 30 x 10(9)/L. Sustained remission could not be achieved in the patients treated with IVIG alone. Corticosteroids were used in 6 patients who became refractory to IVIG and resulted in sustained remission in only one patient. Spontaneous remission of thrombocytopenia occurred in one patient. Ten patients were treated with zidovudine (ZVD) for a period of 3-20 months. Sustained improvement in the platelet counts occurred in only three of the children treated with ZVD
— id: 13750, year: 1992, vol: 5, page: 450, stat: Journal Article,

MEASLES INFECTION AND IMMUNOPROPHYLAXIS FAILURE IN HIV INFECTED CHILDREN
CHANDWANI, S; KAUL, A; DIJOHN, D; LEIBOVITZ, E; POLLACK, H; BORKOWSKY, W; KRASINSKI, K
1991 APR ;29(4):A168-A168, Pediatric research
— id: 51664, year: 1991, vol: 29, page: A168, stat: Journal Article,

LACK OF CYTOMEGALOVIRUS COFACTOR EFFECT ON PERINATAL HIV-INFECTION
KRASINSKI, K; KAUL, A; POLLACK, H; DIJOHN, D; BEBENROTH, D; KIM, M; BORKOWSKY, W
1991 APR ;29(4):A176-A176, Pediatric research
— id: 51666, year: 1991, vol: 29, page: A176, stat: Journal Article,

Disseminated fungal infections in children infected with human immunodeficiency virus
Leibovitz E; Rigaud M; Chandwani S; Kaul A; Greco MA; Pollack H; Lawrence R; Di John D; Hanna B; Krasinski K; et al
1991 Dec;10(12):888-894, Pediatric infectious disease journal
A retrospective review of charts of 156 human immunodeficiency virus-infected children cared for during a 7.5-year period revealed 11 episodes of disseminateed candidiasis (DC) occurring in 11 patients (7%). All 11 patients developed the fungal infection in the context of advanced human immunodeficiency virus infection. All but one were hospital-acquired, occurring at a mean of 2.3 months after admission. Ten patients had been febrile for more than 14 days before diagnosis. Previous oral thrush and central venous catheters (73 and 82% of patients) represented major predisposing factors for development of DC. Neutropenia (2 of 11 patients) did not represent a major risk factor for DC. Candida albicans was isolated in 9 patients, Rhodotorula minuta in 1 patient and 1 fungal isolate could not be identified. Sources of isolation were blood (8 of 11 patients), central venous catheters (3 of 11) and urine (2 of 11). Lungs (6 of 11 patients), esophagus (5 of 11) and brain, heart and kidneys (3 patients each) were the organs most often involved in DC. Antemortem diagnosis was achieved in only 7 (64%) patients; none of the 4 patients with DC diagnosed postmortem had been treated before death. Seven patients were treated with amphotericin B; 6 of them died but only 3 were treated for more than 7 days of therapy. The overall mortality was 90% (10 of 11 patients). In all 20% of the 50 human immunodeficiency virus-infected children who died at our hospital during the study period had an episode of DC in close proximity to their death. DC was considered the direct cause of death in 4 of 10 children
— id: 13828, year: 1991, vol: 10, page: 888, stat: Journal Article,

SYSTEMIC FUNGAL-INFECTIONS (SFI) IN CHILDREN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS (HIV)
LEIBOVITZ, E; RIGAUD, M; CHANDWANI, S; KAUL, A; GRECO, MA; POLLACK, H; LAWRENCE, R; DIJOHN, D; KRASINSKI, K; BORKOWSKY, W
1991 APR ;29(4):A177-A177, Pediatric research
— id: 51667, year: 1991, vol: 29, page: A177, stat: Journal Article,

DELAYED RECOGNITION OF PEDIATRIC HIV-INFECTION IN PREADOLESCENT CHILDREN
PERSAUD, D; CHANDWANI, S; RIGAUD, M; LEIBOVITZ, E; KAUL, A; LAWRENCE, R; POLLACK, H; DIJOHN, D; KRASINSKI, K; BORKOWSKY, W
1991 APR ;29(4):A181-A181, Pediatric research
— id: 51668, year: 1991, vol: 29, page: A181, stat: Journal Article,

LIMITATIONS OF INVITRO ANTIBODY (IVAB) ASSAY IN THE EARLY DIAGNOSIS OF HIV-INFECTION IN INFANTS
POLLACK, H; ZHAN, MX; MOORE, T; AJUANGSIMHIRI, K; KRASINSKI, K; BORKOWSKY, W
1991 APR ;29(4):A182-A182, Pediatric research
— id: 51669, year: 1991, vol: 29, page: A182, stat: Journal Article,

THROMBOCYTOPENIA IN CHILDREN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) - LONG-TERM FOLLOW-UP AND THERAPEUTIC CONSIDERATIONS
RIGAUD, M; LEIBOVITZ, E; SINQUEE, C; KAUL, A; NARDI, M; POLLACK, H; LAWRENCE, R; DIJOHN, D; KRASINSKI, K; KARPATKIN, M; BORKOWSKY, W
1991 APR ;29(4):A182-A182, Pediatric research
— id: 51670, year: 1991, vol: 29, page: A182, stat: Journal Article,

CYTOMEGALOVIRUS INFECTIONS IN CHILDREN AT RISK FOR HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION
KRASINSKI, K; BORKOWSKY, W; POLLACK, H; DIJOHN, D; KAUL, A; BEBENROTH, D; FIDELIA, A; MOORE, T
1990 APR ;27(4):A175-A175, Pediatric research
— id: 51498, year: 1990, vol: 27, page: A175, stat: Journal Article,

Pneumocystis carinii pneumonia in infants infected with the human immunodeficiency virus with more than 450 CD4 T lymphocytes per cubic millimeter
Leibovitz E; Rigaud M; Pollack H; Lawrence R; Chandwani S; Krasinski K; Borkowsky W
1990 Aug 23;323(8):531-533, New England journal of medicine
— id: 14562, year: 1990, vol: 323, page: 531, stat: Journal Article,

THE PRODUCTION OF ANTI-HIV ANTIBODIES INVITRO IN CHILDREN AND ADULTS
Pollack, H; Moore, T; Krasinski, K; Xia, ZM; Borkowsky, W
1989 Apr;25(4):A167-A167, Pediatric research
— id: 31731, year: 1989, vol: 25, page: A167, stat: Journal Article,

ANGIOMYOLIPOMA (HAMARTOMA) OF KIDNEY - ANGIOGRAPHIC REVIEW
BECKER, JA; KINKHABW.M; POLLACK, H; BOSNIAK, M
1973 ;14(5):561-568, Acta radiologica. Diagnosis
— id: 39768, year: 1973, vol: 14, page: 561, stat: Journal Article,