Journal article

Cost-effectiveness of routine and low-cost CD4 T-cell count compared with WHO clinical staging of HIV to guide initiation of antiretroviral therapy in resource-limited settings

Eugene Athan, Daniel P O'Brien, Rosa Legood

AIDS | LIPPINCOTT WILLIAMS & WILKINS | Published : 2010

Abstract

BACKGROUND: HIV is a major cause of disease and death in sub-Saharan Africa. Provision and scale-up of antiretroviral therapy (ART) in resource-limited settings is feasible and cost-effective. Initiation of ART is guided by WHO stage or CD4 cell count; the latter may not be available and up to 70% of eligible individuals are not identified. Low-cost CD4 cell count tests are comparable to conventional methods. We compared the direct healthcare costs and benefits using routine and low-cost CD4 cell count versus WHO staging to initiate ART. METHODS: Using a Markov state transition model, we incorporated costs, survival and quality of life. We compared the direct healthcare costs and benefits in..

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