Cost-effectiveness of early identification of HIV infection

Early treatment of HIV-infected individuals with antiretroviral therapy (ART) is widely recognised not only to improve long-term outcomes for patients, 1 Group ISS Lundgren JD Babiker AG et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015; 373: 795-807 Crossref PubMed Scopus (2) Google Scholar but also to prevent HIV transmission. 2 Cohen MS Chen YQ McCauley M et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011; 365: 493-505 Crossref PubMed Scopus (5387) Google Scholar Consequently, immediate treatment is now recommended by WHO. 3 WHOConsolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. 2nd edn. World Health Organization, Geneva2016 Google Scholar Although treatment is available, a large proportion of individuals present late into care (CD4 count <350 cells per μL). Even in the UK, which has good health-care access, about 40% of people infected with HIV present late for care, stymieing the potential preventive effect of treatment. 4 Skingsley A Kirwan P Yin Z et al. HIV new diagnoses, treatment and care in the UK: 2015 Report. Public Health England, London2015 Google Scholar Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysisScreening for HIV in primary care has important public health benefits as well as clinical benefits. We predict it to be cost-effective in the UK in the medium term. However, this intervention might be cost-effective far sooner, and even cost-saving, in settings where long-term health-care costs of late-diagnosed patients in high-prevalence regions are much higher (≥60%) than those of patients diagnosed earlier. Screening for HIV in primary care is cost-effective and should be promoted. Full-Text PDF Open Access