Virologic monitoring can be a cost-effective strategy to diagnose treatment failure on first-line ART

Alain M. Vandormael, David R. Boulware, Frank C. Tanser, Till W. Bärnighausen, Katharine E. Stott, Tulio De Oliveira

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

CD4 count testing is perceived to be an affordable strategy to diagnose treatment failure on first-line antiretroviral therapy. We hypothesize that the superior accuracy of viral load (VL) testing will result in less patients being incorrectly switched to more expensive and toxic second-line regimens. Using data from a drug resistance cohort, we show that CD4 testing is approximately double the cost to make 1 correct regimen switch under certain diagnostic thresholds (CD4 = US $499 vs. VL = US $186 or CD4 = US $3031 vs. VL = US $1828). In line with World Health Organization guidelines, our findings show that VL testing can be both an accurate and cost-effective treatment monitoring strategy.

Original languageEnglish (US)
Pages (from-to)462-466
Number of pages5
JournalJournal of acquired immune deficiency syndromes (1999)
Volume71
Issue number4
DOIs
StatePublished - 2016

Keywords

  • Antiretroviral therapy
  • CD4 cell count
  • Cost-effectiveness
  • Drug resistance
  • HIV
  • Monitoring
  • South Africa
  • Treatment failure
  • Viral load

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

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