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Your search found 3 Results

  1. 1
    391053
    Peer Reviewed

    Initiation of antiretroviral therapy based on the 2015 WHO guidelines.

    Kuznik A; Iliyasu G; Habib AG; Musa BM; Kambugu A; Lamorde M

    AIDS. 2016 Nov 28; 30(18):2865-2873.

    OBJECTIVE: In 2015, the WHO recommended initiation of antiretroviral therapy (ART) in all HIV-positive patients regardless of CD4 cell count. We evaluated the cost-effectiveness of immediate versus deferred ART initiation among patients with CD4 cell counts exceeding 500cells/mul in four resource-limited countries (South Africa, Nigeria, Uganda, and India). DESIGN: A 5-year Markov model with annual cycles, including patients at CD4 cell counts more than 500 cells/mul initiating ART or deferring therapy until historic ART initiation criteria of CD4 cell counts more than 350 cells/mul were met. METHODS: The incidence of opportunistic infections, malignancies, cardiovascular disease, unscheduled hospitalizations, and death, were informed by the START trial results. Risk of HIV transmission was obtained from a systematic review. Disability weights were based on published literature. Cost inputs were inflated to 2014 US dollars and based on local sources. Results were expressed in cost per disability-adjusted life years averted and measured against WHO cost-effectiveness thresholds. RESULTS: Immediate initiation of ART is associated with a cost per disability-adjusted life years averted of -$317 [95% confidence interval (CI): -$796-$817] in South Africa; -$507 (95% CI: -$765-$837) in Nigeria; -$136 (-$382-$459) in Uganda; and -$78 (-$256-$374) in India. The results are largely driven by the impact of ART on reducing the risk of new HIV transmissions. CONCLUSIONS: In HIV-positive patients with CD4 counts above 500 cells/mul in the four studied countries, immediate initiation of ART versus deferred therapy until historic eligibility criteria are met is cost-effective and likely even cost-saving over time.
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  2. 2
    352280
    Peer Reviewed

    The impact of the new WHO antiretroviral treatment guidelines on HIV epidemic dynamics and cost in South Africa.

    Hontelez JA; de Vlas SJ; Tanser F; Bakker R; Barnighausen T; Newell ML; Baltussen R; Lurie MN

    PloS One. 2011; 6(7):e21919.

    BACKGROUND: Since November 2009, WHO recommends that adults infected with HIV should initiate antiretroviral therapy (ART) at CD4+ cell counts of
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  3. 3
    312815

    Evaluation of the United Nations Declaration on HIV / AIDS resource targets.

    Teixeira L

    Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:52-59.

    This study evaluates the targets of the United Nations Declaration on HIV/AIDS Resource Targets, the attainment of which are premised on promoting three fronts: reduction of material and services costs, increased efficiency in access to and management of funds, and the channeling of new funds. Data were derived from studies of National Accounts of HIV/AIDS in Latin America and the Caribbean and from the recent available literature on the global dynamics of HIV/AIDS resources. The economic concept of global public good occurs throughout the text. The article discusses factors that constrain funding, and thus compel the adoption of new strategies in Brazil. The issues addressed include: difficulties in maintaining the downward tendency in the cost of items related to the HIV/AIDS epidemic, the incorporation each year of thousands of persons needing antiviral therapy, the rise in patient survival and increased diagnosis for the control of HIV/AIDS transmission. It is concluded that, in order to guarantee additional resources to combat the epidemic, the discussion on funding must necessarily focus on both the share of AIDS support for the Brazilian Ministry of Health, and, more importantly, on an increase in health funding as a whole. The recognition that HIV/AIDS control contributes to the global public good should facilitate increases in development assistance from international funding sources. (author's)
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