Washington, Oct 1: Early initiation of antiretroviral therapy (ART) for HIV-infected individuals- with uninfected sexual partners to prevent viral transmission appears to make economic sense, along with meeting its clinical goals of helping infected patients stay healthy and reducing transmission.
A model-based analysis of data from an important clinical trial projected that early ART for such patients in both South Africa and India would be very cost-effective over the lifetime of patients.
“By demonstrating that early HIV therapy not only has long-term clinical benefits to individuals but also provides excellent economic value in both low- and middle-income countries, this study provides a critical answer to an urgent policy question,” Rochelle Walensky, from the Massachusetts General Hospital (MGH) Division of Infectious Disease said.
In 2011 the HIV Prevention Trials Network – an international research collaborative – published results of a trial showing that treatment as prevention dramatically reduced the risks of viral transmission and also substantially cut the time to AIDS-related events and infections like tuberculosis in the HIV-infected patients.
The results indicated that, during the first five years, 93 percent of patients receiving early ART would survive, compared with 83 percent of those whose treatment was delayed. Life expectancy for the early-treatment group was almost 16 years, compared with nearly 14 years for the delayed treatment group.
During the first five years, the potential costs of infections that were prevented by early treatment in South Africa – particularly tuberculosis – would outweigh the costs of ART medications, indicating that the strategy actually would save overall costs.
While this was not the case for India, where costs of care for opportunistic infections are less, early ART in that country was projected to be cost-effective, according to established standards. Across patient lifetimes, early ART was determined to be very cost effective in both countries. Most of the clinical benefits were seen in the infected patients – fewer illnesses and deaths – and there were also added clinical and economic benefits from reducing HIV transmission.
The study is published in New England Journal of Medicine. (ANI)