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:12/2/2016)... ... 2016 , ... Center for Autism and Related Disorders (CARD) Portland today announced ... disorder (ASD) and other developmental disabilities. The group, which is being launched with the ... the opportunity to share stories and advice, seek help, and continue their education on ...
(Date:12/2/2016)... ... 2016 , ... U.S. Surgeon General, Dr. Vivek Murthy, graces the cover of ... was inspired to practice medicine at an early age by his father, who was ... diagnoses and prescribing medicine,” he states. “It is about building relationships with people; relationships ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... two ostomy patients, standing as living proof that attitude and determination can combine ... and issues that spike around the holidays. This campaign will offer patients a ...
(Date:12/2/2016)... ... December 02, 2016 , ... More than half of American teens report losing ... report speaking with their child about sex related topics, less than 60 percent spoke ... proud to announce the launch of its second edition of the “Sexual Wellness” campaign, ...
(Date:12/2/2016)... ... 02, 2016 , ... CloudLIMS.com, a class-leading provider of Laboratory ... CloudLIMS Lite helps biobanks, clinical, research and testing laboratories keep track of their ... version is a faster and a more efficient product, allowing batch processing of ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... -- UCB is pleased to announce that 12 scientific abstracts have ... American Epilepsy Society (AES) Annual Meeting, which takes place ... USA. 1-12 Data being presented include ... ® (lacosamide) CV and BRIVIACT ® (brivaracetam) CV. ... state of the union of epilepsy care and antiepileptic drugs ...
(Date:12/2/2016)... -- Allergan plc (NYSE: AGN ), a leading ... announced Accelerated Share Repurchase (ASR) Program. Logo - ... , ... announced, the Company entered into a variable tenor ASR arrangement ... $10 billion of its ordinary shares. Approximately 40.5 million shares ...
(Date:11/30/2016)... , Nov 30, 2016 Research and ... Intracranial Pressure Monitoring Devices 2017 - MedCore" report to their offering. ... , , ... brain and the skull. In healthy individuals, it is circulated though the ... are cases where the amount of CSF surrounding the brain changes significantly. ...
Breaking Medicine Technology: