PLoS ONE (Jan 2019)

Cost-effectiveness and budget impact of immediate antiretroviral therapy initiation for treatment of HIV infection in Côte d'Ivoire: A model-based analysis.

  • Eric N Ouattara,
  • Rachel L MacLean,
  • Christine Danel,
  • Ethan D Borre,
  • Delphine Gabillard,
  • Mingshu Huang,
  • Raoul Moh,
  • A David Paltiel,
  • Serge P Eholié,
  • Rochelle P Walensky,
  • Xavier Anglaret,
  • Kenneth A Freedberg

DOI
https://doi.org/10.1371/journal.pone.0219068
Journal volume & issue
Vol. 14, no. 6
p. e0219068

Abstract

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IntroductionThe Temprano and START trials provided evidence to support early ART initiation recommendations. We projected long-term clinical and economic outcomes of immediate ART initiation in Côte d'Ivoire.MethodsWe used a mathematical model to compare three potential ART initiation criteria: 1) CD4 ResultsImmediate ART increased life expectancy by 0.34 years compared to ARTConclusionsIn Côte d'Ivoire, immediate compared to later ART initiation will increase life expectancy, decrease HIV transmission, and be cost-effective over the long-term, with modest budget impact. Immediate ART initiation is an appropriate, high-value standard of care in Côte d'Ivoire and similar settings.