Modeling Outcomes of Earlier ART Initiation in the U.S.

Initiation at CD4 counts >500 cells/mm³ rather than <200 cells/mm³ resulted in 59% higher lifetime costs, but a 24% longer life expectancy and a nearly 50% decrease in HIV transmissions.

Modeling outcomes in HIV care can provide insight into future trends and costs relating to various care strategies. Now, researchers have used a Monte Carlo health-state transition simulation to predict long-term outcomes for a hypothetical 10,000 patients in each of four CD4-count categories on care entry: ≤200, 201–350, 351–500, and 501–900 cells/mm³. They assumed that a patient entering care at a CD4 count >500 cells/mm³ would not initiate antiretroviral therapy (ART) until the count decreased to 500 cells/mm³ and that all patients would remain in continuous care. The cost of care (in 2011 U.S. dollars, discounted by 3%) was based on published data, with the model estimating years until AIDS onset, life expectancy, duration of sequential…

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Modeling Outcomes of Earlier ART Initiation in the U.S.

Topics

Reviewing Author