{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:10:45Z","timestamp":1786961445386,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Many children and adolescents living with HIV still present with severe immunosuppression with morbidity and mortality remaining high in those starting antiretroviral therapy (ART) when hospitalized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The major causes of morbidity and mortality in children living with HIV are pneumonia, tuberculosis, bloodstream infections, diarrhoeal disease and severe acute malnutrition. In contrast to adults, cryptococcal meningitis is rare in children under 5 years of age but increases in adolescence. In 2021, the World Health Organizations (WHO) consolidated guidelines for managing HIV disease and rapid ART included recommendations for children and adolescents. In addition, a WHO technical brief released in 2020 highlighted the various interventions that are specifically related to children and adolescents with advanced HIV disease (AHD). We discuss the common clinical presentations of children and adolescents with AHD with a focus on diagnosis, prevention and treatment, highlight some of the challenges in the implementation of the existing package of care, and emphasize the importance of additional research to address the needs of children and adolescents with AHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are limited data informing these recommendations and an urgent need for further research on how to implement optimal strategies to ensure tailored approaches to prevent and treat AHD in children and adolescents. Holistic care that goes beyond a simple choice of ART regimen should be provided to all children and adolescents with AHD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26041","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T17:07:16Z","timestamp":1679418436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The hard part we often forget: providing care to children and adolescents with advanced HIV disease"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-3128","authenticated-orcid":false,"given":"Lisa Jane","family":"Frigati","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health Stellenbosch University, Tygerberg Academic Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Gibb","sequence":"additional","affiliation":[{"name":"Medical Research Council Clinical Trials Unit at University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8853-9603","authenticated-orcid":false,"given":"Joseph","family":"Harwell","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3569-8811","authenticated-orcid":false,"given":"Judith","family":"Kose","sequence":"additional","affiliation":[{"name":"Technical Strategy and Innovation The Elizabeth Glaser Pediatric AIDS Foundation  Nairobi Kenya"},{"name":"Erasmus MC Department of Viroscience Erasmus University  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Musiime","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health Makerere University  Kampala Uganda"},{"name":"Research Department Joint Clinical Research Centre  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Rabie","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health Stellenbosch University, Tygerberg Academic Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Rangaraj","sequence":"additional","affiliation":[{"name":"World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Rojo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Universitario Doce de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Turkova","sequence":"additional","affiliation":[{"name":"Medical Research Council Clinical Trials Unit at University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5485-8692","authenticated-orcid":false,"given":"Martina","family":"Penazzato","sequence":"additional","affiliation":[{"name":"World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"UNAIDS. 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