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COMMENTS AND OPINIONS
Cost-effectiveness of Strategies for Monitoring the Response to Antiretroviral Therapy in Resource-Limited Settings
Andrew N. Phillips, PhD;
Charles Gilks, DPhil;
Jens D. Lundgren, MD, DMSc
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Based on a computer simulation model, Bendavid and colleagues1 compared the benefits and costs of different approaches to monitoring people with human immunodeficiency virus in resource-limited settings, concluding that monitoring with CD4 counts was beneficial compared with symptom-based approaches. The CD4 count monitoring strategies that were considered involved the use of CD4 count monitoring to decide (1) when to start antiretroviral treatment (ART) and (2) when to switch to second-line regimens for patients already receiving ART. It would be helpful if the authors are able to run models that consider these 2 components in isolation from each other. The use of CD4 counts rather than the presence of symptoms to decide when to start treatment (the first component) results in starting ART at a higher CD4 count, which is known to be associated with lower death rates,2 so . . . [Full Text of this Article]
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ABSTRACT
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