Trial reportPLoS medicine2011
Cost-effectiveness of early versus standard antiretroviral therapy in HIV-infected adults in Haiti.
Trial report in PLoS medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00120510 (A Randomized Clinical Trial to Determine the Efficacy of Early Versus Standard Antiretroviral Therapy in HIV Infected Adults With CD4+ T Cell Counts Between 200 and 350 Cells/mm3), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Clinical Trial to Determine the Efficacy of Early Versus Standard Antiretroviral Therapy in HIV Infected Adults With CD4+ T Cell Counts Between 200 and 350 Cells/mm3
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rapid initiation of antiretroviral therapy for people living with HIV.The Cochrane database of systematic reviews · 2019Pooled it
- Trial
- Meta-Analysis of Cost-Effectiveness.Statistics in medicine · 2026Article
- Mean Cost and Cost-Effectiveness Ratios with Censored Data: a Tutorial and SASBiostatistics & epidemiology · 2025Article
- Impact of Age and Gender Disparity on CD4+ Cell Counts to Control Disease Progression Using Specific HAART in HIV-1 Positive Patients: A Case-Control Study.Reviews on recent clinical trials · 2022Article
- Research priorities to inform "Treat All" policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA).Journal of the International AIDS Society · 2019Article
- Early Treatment in HIV Patients: A Cost-Utility Analysis from the Italian Perspective.Clinical drug investigation · 2016Article
- Prioritizing health system and disease burden factors: an evaluation of the net benefit of transferring health technology interventions to different districts in Zimbabwe.ClinicoEconomics and outcomes research : CEOR · 2016Article
- Superior outcomes and lower outpatient costs with scale-up of antiretroviral therapy at the GHESKIO clinic in Port-au-Prince, Haiti.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- CD4+ cell count at antiretroviral therapy initiation and economic restoration in rural Uganda.AIDS (London, England) · 2014Article
- Cost-Effectiveness of Improving Health Care to People with HIV in Nicaragua.Nursing research and practice · 2014Article
- The Haiti research-based model of international public health collaboration: the GHESKIO Centers.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- Article
- HIV in Africa: Challenges and Directions for the Next Decade.Current infectious disease reports · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundIn a randomized clinical trial of early versus standard antiretroviral therapy (ART) in HIV-infected adults with a CD4 cell count between 200 and 350 cells/mm³ in Haiti, early ART decreased mortality by 75%. We assessed the cost-effectiveness of early versus standard ART in this trial. METHODS AND
findingsTrial data included use of ART and other medications, laboratory tests, outpatient visits, radiographic studies, procedures, and hospital services. Medication, laboratory, radiograph, labor, and overhead costs were from the study clinic, and hospital and procedure costs were from local providers. We evaluated cost per year of life saved (YLS), including patient and caregiver costs, with a median of 21 months and maximum of 36 months of follow-up, and with costs and life expectancy discounted at 3% per annum. Between 2005 and 2008, 816 participants were enrolled and followed for a median of 21 months. Mean total costs per patient during the trial were US$1,381 for early ART and US$1,033 for standard ART. After excluding research-related laboratory tests without clinical benefit, costs were US$1,158 (early ART) and US$979 (standard ART). Early ART patients had higher mean costs for ART (US$398 versus US$81) but lower costs for non-ART medications, CD4 cell counts, clinically indicated tests, and radiographs (US$275 versus US$384). The cost-effectiveness ratio after a maximum of 3 years for early versus standard ART was US$3,975/YLS (95% CI US$2,129/YLS-US$9,979/YLS) including research-related tests, and US$2,050/YLS excluding research-related tests (95% CI US$722/YLS-US$5,537/YLS).
conclusionsInitiating ART in HIV-infected adults with a CD4 cell count between 200 and 350 cells/mm³ in Haiti, consistent with World Health Organization advice, was cost-effective (US$/YLS <3 times gross domestic product per capita) after a maximum of 3 years, after excluding research-related laboratory tests.
trial registrationClinicalTrials.gov NCT00120510.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.