Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Expanding ART for treatment and prevention of HIV in South Africa: Estimated cost and cost-effectiveness 2011-2050
PLoS ONE, Volume 7, No. 2, Article e30216, Year 2012
Notification
URL copied to clipboard!
Description
Background: Antiretroviral Treatment (ART) significantly reduces HIV transmission. We conducted a cost-effectiveness analysis of the impact of expanded ART in South Africa. Methods: We model a best case scenario of 90% annual HIV testing coverage in adults 15-49 years old and four ART eligibility scenarios: CD4 count <200 cells/mm 3 (current practice), CD4 count <350, CD4 count <500, all CD4 levels. 2011-2050 outcomes include deaths, disability adjusted life years (DALYs), HIV infections, cost, and cost per DALY averted. Service and ART costs reflect South African data and international generic prices. ART reduces transmission by 92%. We conducted sensitivity analyses. Results: Expanding ART to CD4 count <350 cells/mm 3 prevents an estimated 265,000 (17%) and 1.3 million (15%) new HIV infections over 5 and 40 years, respectively. Cumulative deaths decline 15%, from 12.5 to 10.6 million; DALYs by 14% from 109 to 93 million over 40 years. Costs drop $504 million over 5 years and $3.9 billion over 40 years with breakeven by 2013. Compared with the current scenario, expanding to <500 prevents an additional 585,000 and 3 million new HIV infections over 5 and 40 years, respectively. Expanding to all CD4 levels decreases HIV infections by 3.3 million (45%) and costs by $10 billion over 40 years, with breakeven by 2023. By 2050, using higher ART and monitoring costs, all CD4 levels saves $0.6 billion versus current; other ART scenarios cost $9-194 per DALY averted. If ART reduces transmission by 99%, savings from all CD4 levels reach $17.5 billion. Sensitivity analyses suggest that poor retention and predominant acute phase transmission reduce DALYs averted by 26% and savings by 7%. Conclusion: Increasing the provision of ART to <350 cells/mm3 may significantly reduce costs while reducing the HIV burden. Feasibility including HIV testing and ART uptake, retention, and adherence should be evaluated. © 2012 Granich et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3278413/bin/pone.0030216.s001.doc
Authors & Co-Authors
Granich, Reuben M.
Switzerland, Geneva
Organisation Mondiale de la Santé
Kahn, James G.
United States, San Francisco
University of California, San Francisco
Bennett, R.
Unknown Affiliation
Holmes, Charles B.
United States, Washington, D.c.
U.s. Department of State
Garg, Navneet
Switzerland, Lausanne
Vestergaard Frandsen
Serenata, Celicia M.
South Africa
South African National Aids Council
Sabin, Miriam Lewis
Switzerland, Geneva
Organisation Mondiale de la Santé
Makhlouf-Obermeyer, Carla
Switzerland, Geneva
Organisation Mondiale de la Santé
de Filippo Mack, Christina
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Williams, Phoebe C.M.
Switzerland, Geneva
Organisation Mondiale de la Santé
Jones, Louisa
Switzerland, Geneva
Organisation Mondiale de la Santé
Smyth, Caoimhe
Switzerland, Geneva
Organisation Mondiale de la Santé
Kutch, Kerry A.
Switzerland, Geneva
Organisation Mondiale de la Santé
Ying-Ru, Lo
Switzerland, Geneva
Organisation Mondiale de la Santé
Vitória, Marco Antônio De Ávila
Switzerland, Geneva
Organisation Mondiale de la Santé
Souteyrand, Yves P.
Switzerland, Geneva
Organisation Mondiale de la Santé
Crowley, Siobhan
Switzerland, Geneva
Organisation Mondiale de la Santé
Korenromp, Eline L.
Switzerland, Geneva
Fonds Mondial de Lutte Contre le Sida, la Tuberculose et le Paludisme
Netherlands, Rotterdam
Erasmus Mc
Williams, Brian Gerard
South Africa, Stellenbosch
Stellenbosch University
Statistics
Citations: 167
Authors: 19
Affiliations: 9
Identifiers
Doi:
10.1371/journal.pone.0030216
e-ISSN:
19326203
Research Areas
Disability
Health System And Policy
Infectious Diseases
Study Locations
South Africa