The NYU Devision of Pediatric Infectious Diseases utilizes state-of-the-art technologies to develop assays which permit the early diagnosis of HIV infection in children, and to examine primary HIV infection and recurrent and opportunistic infections in HIV-infected children.

Diagnosis of HIV Infection in Children

• P24 antigenemia in the first 2 years of life
• PCR and culture of HIV in the first 6 months of life
• immune-complex dissociated p24 antigenemia in the first 6 months of life
• in vitro antibody production to HIV in young infants
• in vitro p24 antigen production in HIV infected young infants

Primary Infection

• We were the first to describe the presence of seronegative (ELISA negative) HIV infection in children.
• We were the first to describe the correlation between maternal viral burden and HIV transmission.
• We have described the acquisition and loss of specific immune responses in HIV-infected children. This includes a description of the development of memory immune cells in HIV-infected children.
• We have been involved in the clinical, and laboratory evaluation of several antiretroviral drugs.
• We were the first to design a clinical trial of an HIV vaccine in newborns.
• We have documented the immune reconstitution of children with severe immunodepletion after initiating highly active antiretroviral therapy.

Opportunistic Infections

Over the years, our group has been very involved in the study of recurrent and opportunistic infections in HIV-infected children. This has included the following:

• The first compilation of bacterial infections. This information was used to design ACTG 045 and ACTG 051, trials to evaluate IVIG in this population;
• The first report of fatal measles infection in HIV-infected children. This report changed immunization practices in this population by encouraging the use of "live" attenuated measles vaccine, in spite of its limited immunogenicity. The efficacy of measles vaccination has been studied further by our group;
• The first report of P.carinii pneumonia in HIV-infected infants with CD4 counts higher than predicted by the experience in adults. This and other reports resulted in a change in CDC guidelines for PCP prophylaxis in children. This work has continued by correlating disease with anti-PCP antibody, detected by Western blot, as well as the efficacy of PCR for its diagnosis. Most recently, we have also been the first to report the efficacy of PCP prophylaxis;
• The first series describing chronic varicella in HIV-infected children. This resulted in a subsequent analysis of varicella in this population;
• The first report of the outcome of respiratory syncytial virus infection in HIV-infected children, including the risk of secondary infection and the absence of wheezing;
• The first reported case series of disseminated fungal infections in HIV-infected children;
• An ongoing analysis of the role of CMV as a cofactor in HIV disease.
• The relationship between HIV and hepatitis C in children born to mothers coinfected with these viruses.