1 / 9

The Effects of Different ART Eligibility Strategies on HIV-Related Mortality and Incidence

The Effects of Different ART Eligibility Strategies on HIV-Related Mortality and Incidence. John Stover, Carel Pretorius, Lori Bollinger Futures Institute July 23 , 2012 XIX International AIDS Conference, July 22-27, 2012, Washington, DC. Adult CD4 Model. On ART. λ 1. α 1. μ 1. c 1.

olympia-kirkland
Download Presentation

The Effects of Different ART Eligibility Strategies on HIV-Related Mortality and Incidence

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Effects of Different ART Eligibility Strategies on HIV-Related Mortality and Incidence John Stover, Carel Pretorius, Lori Bollinger Futures Institute July 23, 2012 XIX International AIDS Conference, July 22-27, 2012, Washington, DC

  2. Adult CD4 Model On ART λ1 α1 μ1 c1 >500 λ2 α2 μ2 c2 350-499 λ3 α3 μ3 c3 250-349 λ4 μ4 c4 α4 200-249 λ5 μ5 c5 α5 100-199 λ6 α6 μ6 c6 50-99 λ7 α7 μ7 c7 <50 AIDS Death μ = HIV-related mortality rate; λ = Rate of progression to lower CD4 counts; c = Rate of initiating ART; α = HIV-related mortality rate while on ART

  3. Progression (λ) λ values are determined by fitting to ALPHA network patterns of progression to AIDS death and distribution of HIV+ population not on ART by CD4 count from Kenya AIS 2007 subject to the constraint that the annual decline should be constant across CD4 categories.

  4. Effect of ART on Transmission HIV+ Population by CD4 Category Transmission Multiplier 8 – 40 1 3 - 8 0.04 – 0.2 • On ART Combined effect changes with distribution of HIV+ by CD4 count and ART

  5. Scenarios to Model • Eligibility for treatment • CD4 count: • <350 • <500 • All • Pregnant women: • <500 • All • HIV+/TB+ • Discordant couples • Key outputs • New infections • Number on ART • Costs of treatment • PY of Tx per IA • PY of Tx per death averted • Life years gained • $/IA, $/DA, $/LYG

  6. Person-Years of Treatment per Infection Averted (2010-2025)

  7. Additional Cost in Millions of US$ (2010-2025)

  8. Cost per Infection Averted (2010-2025)

  9. Conclusions • Earlier initiation of ART will reduce HIV-related mortality and incidence • Cost per infection averted rises at higher CD4 count thresholds • A major challenge to implementing very early initiation will be findings all those eligible • The most urgent need is to reach all those with CD4 counts under 350

More Related