In a cost-effectiveness study, Bruce R Schackman of Weill Cornell Medical College, USA and colleagues compare early versus standard antiretroviral treatment (ART) for HIV, based on randomized clinical trial data from Haiti. The study reveals that the new WHO guidelines for early ART initiation can be cost-effective in resource-poor settings, information that should help policymakers in developing countries allocate their often limited resources.
The authors say: "Financial and operational resources should be prioritized so that resource-poor countries are able to implement the new WHO guidelines, which recommend treatment for all HIV-infected patients with CD4 cell counts 350 cells/mm3."
Funding: The project was supported in part by grants AI58257 and AI69421 from the US National Institutes of Allergy and Infectious Diseases, and by TW006896, TW006901, TW00018, and TW007142 from the Fogarty International Center. Support for antiretroviral medications was provided by the Global Fund to Fight AIDS, Tuberculosis, and Malaria, Glaxo SmithKline, and Abbott. Support for laboratory testing was provided by the Fondation Mérieux. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Koenig SP, Bang H, Severe P, Jean Juste MA, Ambroise A, et al. (2011) Cost-Effectiveness of Early Versus Standard Antiretroviral Therapy in HIV-Infected Adults in Haiti. PLoS Med 8(9): e1001095. doi:10.1371/journal.pmed.1001095
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Bruce R Schackman
Associate Professor and Chief of Health Policy Division Department of Public Health
Weill Medical College
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