Identifying key drivers of the impact of an HIV cure intervention in sub-Saharan Africa
Autor: | Loveleen Bansi-Matharu, Valentina Cambiano, Travor Mabugu, Mark Sculpher, Sharon R Lewin, Fumiyo Nakagawa, Timothy B. Hallett, Joseph Murungu, Stephen Becker, Steven G. Deeks, Jens D Lundgren, Paul Revill, Andrew N. Phillips, Silvija I. Staprans, Geoff Garnett |
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Přispěvatelé: | Bill & Melinda Gates Foundation |
Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Male economic evaluation Cost effectiveness Cost-Benefit Analysis Psychological intervention HIV Infections Medical and Health Sciences 0302 clinical medicine Theoretical Models Immunology and Allergy Medicine 030212 general & internal medicine health care economics and organizations education.field_of_study Cost–benefit analysis Incidence 1. No poverty 11 Medical And Health Sciences Middle Aged Biological Sciences cure 3. Good health Infectious Diseases HIV/AIDS Female Adult Zimbabwe Adolescent Anti-HIV Agents Population antiretroviral therapy Developing country Microbiology Major Articles and Brief Reports 03 medical and health sciences Young Adult Intervention (counseling) Environmental health Disability-adjusted life year Humans education Poverty Disease burden Aged model business.industry HIV Models Theoretical 06 Biological Sciences 030112 virology Immunology business Forecasting |
Zdroj: | Phillips, A N, Cambiano, V, Revill, P, Nakagawa, F, Lundgren, J D, Bansi-Matharu, L, Mabugu, T, Sculpher, M, Garnett, G, Staprans, S, Becker, S, Murungu, J, Lewin, S R, Deeks, S G & Hallett, T B 2016, ' Identifying Key Drivers of the Impact of an HIV Cure Intervention in Sub-Saharan Africa ', The Journal of Infectious Diseases, vol. 214, pp. 73-79 . https://doi.org/10.1093/infdis/jiw120 The Journal of infectious diseases, vol 214, iss 1 The Journal of Infectious Diseases |
ISSN: | 0022-1899 |
Popis: | BACKGROUND: It is unknown what properties would be required to make an intervention in low income countries that can eradicate or control human immunodeficiency virus (HIV) without antiretroviral therapy (ART) cost-effective.METHODS: We used a model of HIV and ART to investigate the effect of introducing an ART-free viral suppression intervention in 2022 using Zimbabwe as an example country. We assumed that the intervention (cost: $500) would be accessible for 90% of the population, be given to those receiving effective ART, have sufficient efficacy to allow ART interruption in 95%, with a rate of viral rebound of 5% per year in the first 3 months, and a 50% decline in rate with each successive year.RESULTS: An ART-free viral suppression intervention with these properties would result in >0.53 million disability-adjusted-life-years averted over 2022-2042, with a reduction in HIV program costs of $300 million (8.7% saving). An intervention of this efficacy costing anything up to $1400 is likely to be cost-effective in this setting.CONCLUSIONS: Interventions aimed at curing HIV infection have the potential to improve overall disease burden and to reduce costs. Given the effectiveness and cost of ART, such interventions would have to be inexpensive and highly effective. |
Databáze: | OpenAIRE |
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