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首页> 外文期刊>AIDS care. >Effectiveness and cost effectiveness of early and late prevention of HIV/AIDS progression with antiretrovirals or antibiotics in Southern African adults.
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Effectiveness and cost effectiveness of early and late prevention of HIV/AIDS progression with antiretrovirals or antibiotics in Southern African adults.

机译：在南部非洲成年人中，早期和晚期使用抗逆转录病毒药物或抗生素预防HIV / AIDS进展的有效性和成本效益。

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As HIV/AIDS drugs are becoming more widely available in Southern Africa, we compared the effectiveness and cost effectiveness of different treatment options, using a Markov Monte Carlo simulation model based on published estimates of disease progression, treatment effectiveness and health care costs. Cost and outcome values were discounted. Quality of life was considered. Acceptability curves summarized uncertainties. Sensitivity analyses tested assumptions. Results showed that triple antiretroviral therapy (ARV) plus antibiotics would prolong life by 6.7 undiscounted years if provided 'late' (CD4 = 200 cells/microl) and by 9.8 years if provided 'early' (CD4 = 350 cells/microl). The incremental undiscounted costs per year of life gained, compared to no preventive therapy, were Dollars 17 for isoniazid plus cotrimoxazole started late, Dollars 244 for both antibiotics started early, Dollars 2454 for ARV plus antibiotics started late and Dollars 2784 for ARV plus both antibiotics started early. The discounted incremental costs per quality adjusted life year (QALY) gained were, respectively, Dollars 29 saving, Dollars 254, Dollars 4937 and Dollars 3057. Late ARV plus both antibiotics was the strategy most likely to be cost effective if society was willing to pay more than Dollars 2000 per life year gained. Cost-effectiveness estimates were sensitive to discounting and assumed treatment costs but were less sensitive to assumed treatment effectiveness.
机译：随着艾滋病毒/艾滋病药物在南部非洲的普及，我们使用了马尔可夫·蒙特卡洛模拟模型，该模型基于已发表的疾病进展，治疗效果和医疗保健费用估算，比较了不同治疗方案的有效性和成本效益。成本和结果值被打折。考虑了生活质量。可接受性曲线总结了不确定性。敏感性分析检验了假设。结果显示，如果提供“晚期”（CD4 = 200细胞/微升），三联抗逆转录病毒疗法（ARV）和抗生素将延长寿命6.7年（未折现），如果提供“早期”（CD4 = 350细胞/微升），则可延长9.8年。与未进行预防性治疗相比，每生命年增加的未贴现成本为：异烟肼加cotrimoxazole的治疗开始时间为17美元，两种抗生素的治疗开始时间为244美元，抗逆转录病毒和抗生素治疗开始为2454美元，晚期开始，抗病毒药物和两种抗生素治疗为2784美元。开始得早。每个质量调整生命年（QALY）的折现增量成本分别为节省的29美元，254美元，4937美元和3057美元。如果社会愿意支付，晚期抗逆转录病毒药物加两种抗生素都是最有成本效益的策略。每生命年获得超过2000美元。成本效益评估对折现和假定的治疗费用敏感，但对假定的治疗有效性较不敏感。

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