Cardiovascular disease remains the top cause of morbidity and mortality in the United States. Atherosclerotic plaques are known to start in adolescence, and, therefore, young adults can be affected by coronary artery disease. Children with known risk factors, such as genetic predisposition, including familial hyperlipidemias, diabetes, and renal diseases, are at higher risk. With childhood obesity becoming an epidemic in certain parts of the United States, this problem is further highlighted as an important issue affecting children’s health. There are unclear recommendations for pediatricians regarding cholesterol screening of pediatric populations, when to initiate hyperlipidemia treatment with statin therapy, and when to refer to a specialist for further management. This article reviews the epidemiology and pathophysiology of hyperlipidemia, recommendations for screening and types of screening, management (including pharmacology), prognosis, and prevention.

A double-blind, placebo-controlled trial of interferon prophylaxis against viral infections was conducted in renal-transplant recipients receiving standard immunosuprressive therapy with or without antithymocyte globulin. Interferon was administered for six weeks, beginning on the day of transplantation. Cytomegalovirus excretion began earlier and viremia was more frequent in placebo-treated than in interferon-treated patients. Cytomegalovirus viremia correlated with clinical syndromes was more frequent in recipients of antithymocyte globulin. In contrast, neither interferon nor antithymocyte globulin altered excretion of herpes simplex virus. Reversible leukopenia and thrombocytopenia occurred in seven interferon recipients. Patient and graft survival were comparable in interferon and placebo groups. There preliminary results suggest that a six-week course of prophylactic interferon delays shedding of cytomegalovirus and decreases the incidence of viremia after transplantation. In contrast, antithymocyte globulin appears to increase the severity of infection from cytomegalovirus among these patients.

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The anti-HAV prevalence among US-born providers was low, and seropositivity was not associated with employment characteristics, indicating that occupational exposure to HAV is uncommon under non-outbreak circumstances.