Navigation Links
Earlier HIV antiviral treatment can be cost effective in areas of limited resources
Date:7/20/2009

Early initiation of lifesaving antiretroviral therapies should be the standard of care for all HIV-infected patients, even those in countries with limited medical and financial resources, according to a study led by researchers at Massachusetts General Hospital (MGH) and the Desmond Tutu HIV Centre, University of Cape Town, South Africa.

The team reports in the August 4 Annals of Internal Medicine that starting antiretroviral therapy (ART) when the level of CD4 T cells drops below a threshold of 350 per microliter of blood, compared with below 250, would prevent nearly 76,000 deaths and avert 66,000 opportunistic infections over the next five years at an estimated cost of $1,200 per year of life saved. The study's publication coincides with the International AIDS Society Conference meeting which started yesterday in Cape Town.

The study provides strong support for broadening the eligibility standards for ART in settings with sufficient access to drugs, the authors note. In the U.S. and other developed countries, ART is usually initiated when the CD4 count a measure of immune system function drops below 350. Recognizing that ART is both costly and can have significant side effects, the 2006 World Health Organization (WHO) treatment guidelines suggest waiting until CD4 counts drop below 200 or until patients develop AIDS-related complications.

"While those standards accommodate the limited resources and short supply of medications in many settings, the greater prevalence of tuberculosis and other opportunistic infections in places like South Africa argue for earlier treatment initiation, even before the results of ongoing clinical trials are known." says Rochelle Walensky, MD, MPH, of the MGH Division of Infectious Disease, associate professor of Medicine at Harvard Medical School, who led the study.

Definitive clinical trial findings will not be available for several years. Yet in countries like South Africa, which currently has the world's highest burden of HIV infection, information is needed today to guide treatment policies and practices. To address this need, Walensky and colleagues developed a mathematical model to simulate HIV treatment and its associated health and economic outcomes. The model calculated the additional costs of earlier treatment, its potential toxicities and its benefits, including TB prevention. It also calculated how much delaying ART would shorten patients lives and then estimated the cost per extra year of life gained a standard measure of cost-effectiveness of earlier ART initiation.

"The time has come to act on the information we now have, nearly all of which supports starting treatment earlier. We can re-evaluate the situation after the trials, but until those results are available, the evidence points to saving lives with earlier treatment," says co-author, Robin Wood, FCP, MMed, DTM&H, director of the Desmond Tutu HIV Centre at the Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, a leading HIV clinical research group in South Africa


'/>"/>

Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

Related medicine news :

1. Add Earlier Bedtime to Back-to-School List
2. New research may lead to earlier diagnosis and treatment of primary biliary cirrhosis in families
3. New way to diagnose Alzheimers disease promises earlier treatment
4. Earths Oxygen May Have Arrived Earlier
5. Gene-Based Screen Spots Cervical Cancer Earlier
6. FDA Advisory Committee Votes in Favor of Earlier Use of Phosphate Binders in Stage 4 Kidney Disease Patients With Hyperphosphatemia
7. Treadmill training helps Down syndrome babies walk months earlier
8. Rural patients colon and lung cancers diagnosed earlier, Dartmouth research says
9. Trauma earlier in life may affect response to stress years later
10. Huckabees Defense of Earlier, Alarmist AIDS Stance Shows Unsuitability for Presidency, Says AHF
11. Gold nanoparticle probes may allow earlier cancer detection
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/10/2016)... ... February 10, 2016 , ... Gout is like no other ... that is often severe, with intense swelling and redness. It is triggered by the ... but older adults are the most susceptible, according to the February 2016 issue of ...
(Date:2/10/2016)... ... , ... For additional information contact Phyllis Strupp 480-488-5858 , Brain improves with ... Ultimate Guide to Brain Training" by award-winning author Phyllis Strupp explains how ... March 16, 2016. A free review copy is available to the media at ...
(Date:2/10/2016)... ... February 10, 2016 , ... ... Drive, Jacksonville, FL 32224, February 26th: Amateur & Professional Divisions - Time: ... Time: 7:00pm – 10:00pm | Ticket Prices $30, Social Media: http://www.USPoleSportsFed.org ...
(Date:2/10/2016)... Tennessee (PRWEB) , ... February 09, 2016 , ... A ... reins for Summer 2016. FHU President Joe Wiley made the announcement Monday night, Feb. ... Brad Montague, a 2003 graduate of FHU and the creator of GO! Camp, has ...
(Date:2/10/2016)... ... February 10, 2016 , ... It’s that time of year when ... president of the Interscholastic Athletic Association of Maryland (IAAM), Hall of Fame athlete and ... goals are cast aside. , That’s why one of her first decisions when her ...
Breaking Medicine News(10 mins):
(Date:2/9/2016)... REDWOOD CITY, Calif. , Feb. 9, 2016 /PRNewswire/ ... medical device company that is providing innovative evidence-based solutions ... it will release financial results for the fourth quarter ... Monday, February 29, 2016. Company management will host a ... p.m. Eastern Time) on Monday, February 29, 2016. ...
(Date:2/9/2016)... Feb. 9, 2016  Insulet Corporation (NASDAQ: PODD ) ... pump technology with its OmniPod ® ... has been appointed to Insulet,s Board of Directors. With ... eight of whom are independent. --> ... audit and finance experience and a deep knowledge of accounting, ...
(Date:2/9/2016)... 9, 2016 QGEN ... den Abschluss eines Kooperationsvertrags mit 10x Genomics ... in den Bereichen Next-Generation-Sequencing (NGS), Single-Cell-Biology und ... Frankfurt Prime Standard: QIA) gab heute den ... die Entwicklung und Förderung umfassender Lösungen in ...
Breaking Medicine Technology: