{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:43Z","timestamp":1787014303200,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Timely diagnosis of HIV in children remains a challenge in all settings including low\u2010prevalence, high\u2010income countries (HIC). We aimed to characterize the prevalence of late diagnosis, and prior missed diagnostic opportunities among new presentations of paediatric HIV in HIC referred to an international Perinatal Virtual Clinic (PVC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of new paediatric diagnoses in HIC, referred to the PVC between January 2018 and April 2025. Data on demographics, clinical features and HIV virology\/immunology were extracted from standardized referral templates. Cases were categorized as late or non\u2010late diagnosis by age\u2010related CD4 thresholds, and the two groups compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 45 new paediatric HIV diagnoses referred to the PVC from the European region (41), Australia (2) and Chile (2), the median age was 9\u2009years (IQR 0.8\u201313); 66% (27\/41) were migrants, predominantly from sub\u2010Saharan Africa; 39% (16\/41) were born in HIC. Most (27\/45;60%) were tested due to symptoms; 21\/45 (47%) were diagnosed with AIDS. The median CD4 count was 230 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (IQR 24.5\u2013531), viral load (VL) 316\u2009000 copies\/mL (IQR 65\u2009150\u20131\u2009315\u2009\u2009000) with 31\/45 (69%) meeting criteria for late diagnosis. Late\u2010diagnosed children had significantly higher VL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and were more likely to have prior symptomatic healthcare encounters (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite access to prevention and screening, late paediatric HIV diagnosis persists in HIC, with severe immunosuppression and missed opportunities for earlier recognition and treatment initiation. Improved implementation of family\u2010based screening, particularly following parental\/sibling diagnosis or migration from endemic areas, and education of healthcare providers regarding HIV indicator diseases in children are essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70164","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T03:38:51Z","timestamp":1765597131000},"page":"477-484","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Late diagnosis of paediatric\n                    <scp>HIV<\/scp>\n                    infection in high\u2010income countries: Lessons from the\n                    <scp>HIV<\/scp>\n                    Perinatal Virtual Clinic"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4254-0630","authenticated-orcid":false,"given":"Carolina","family":"Curto","sequence":"first","affiliation":[{"name":"Santo Ant\u00f3nio Local Health Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Tritzali","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bamford","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"},{"name":"UCL Great Ormond Street Institute of Child Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Buckinghamshire Healthcare NHS Trust  Buckinghamshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. G. H.","family":"Lyall","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. E.","family":"Mackie","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Tickner","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8278-8564","authenticated-orcid":false,"given":"C.","family":"Foster","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PVC","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Fact Sheet 2024 \u2013 Latest Global and Regional HIV Statistics.2024https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000881"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25617"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002410"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13177"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13425"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05261-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.106995"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30037-7"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003052"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001883"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad626"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001542"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-307019"},{"key":"e_1_2_9_16_1","unstructured":"World Health Organization.The advanced HIV disease research landscape [Internet]. Geneva.2024.https:\/\/www.who.int\/publications\/i\/item\/9789240089020"},{"key":"e_1_2_9_17_1","unstructured":"ClinicalInfo. U.S. Department of Health and Human Service.HIV\/AIDS Glossary.2021.https:\/\/clinicalinfo.hiv.gov\/sites\/default\/files\/glossary\/Glossary-English_HIVinfo.pdf"},{"key":"e_1_2_9_18_1","unstructured":"WHO.HIV\/AIDS surveillance in Europe 2024: 2023 data [Internet]. Copenhagen2024.https:\/\/iris.who.int\/handle\/10665\/379629"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004822"},{"key":"e_1_2_9_20_1","unstructured":"WHO.Consolidated guidelines on HIV prevention testing treatment service delivery and monitoring: recommendations for a public health approach [Internet].2021.https:\/\/www.who.int\/publications\/i\/item\/9789240031593"},{"key":"e_1_2_9_21_1","unstructured":"European Centre for Disease Prevention and Control (ECDC).HIV and migrants: Monitoring implementation of the Dublin Declaration on partnership to fight HIV\/AIDS in Europe and Central Asia: 2022 progress report [Internet].2023. Available from:https:\/\/www.ecdc.europa.eu\/en\/publications\u2010data\/hiv\u2010and\u2010migrants\u2010monitoring\u2010implementation\u2010dublin\u2010declaration\u2010partnership\u2010fight"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:55:41Z","timestamp":1773399341000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/hiv.70164"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70164","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"assertion":[{"value":"2025-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}