ArticlePloS one2011
The cost-effectiveness of early access to HIV services and starting cART in the UK 1996-2008.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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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.
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Who cites it
18 citing papers in PubMed, 47 citations in OpenAlex.
- Evaluation of an educational intervention to increase HIV-testing in high HIV prevalence general practices: a pilot feasibility stepped-wedged randomised controlled trial.BMC family practice · 2018Trial
- Staff perspectives on implementing opt-out blood-borne virus testing in English emergency departments: a qualitative study.Emergency medicine journal : EMJ · 2026Article
- Developing the PATH-GP (Prevention and Testing for HIV in General Practice) intervention: a person-based approach intervention development study to increase HIV testing and PrEP access.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Evaluating Cost-Effectiveness of Antiretroviral Therapy over Time: A Cohort and Cost-Effectiveness Study.PharmacoEconomics - open · 2024Article
- Evaluating the impact of post-trial implementation of RHIVA nurse-led HIV screening on HIV testing, diagnosis and earlier diagnosis in general practice in London, UK.EClinicalMedicine · 2020Article
- Trends in HIV testing in the UK primary care setting: a 15-year retrospective cohort study from 2000 to 2015.BMJ open · 2019Article
- Qualitative evaluation of a pilot educational intervention to increase primary care HIV-testing.BMC family practice · 2019Article
- Economic evaluation of HIV pre-exposure prophylaxis among men-who-have-sex-with-men in England in 2016.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2017Article
- Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.The lancet. HIV · 2017Article
- A novel strategy to reduce very late HIV diagnosis in high-prevalence areas in South-West England: serious incident audit.Journal of public health (Oxford, England) · 2017Article
- A facility location model for analysis of current and future demand for sexual health services.PloS one · 2017Article
- Early Treatment in HIV Patients: A Cost-Utility Analysis from the Italian Perspective.Clinical drug investigation · 2016Article
- Economic and health implications from earlier detection of HIV infection in the United Kingdom.HIV/AIDS (Auckland, N.Z.) · 2016Article
- Article
- Expanded HIV testing in low-prevalence, high-income countries: a cost-effectiveness analysis for the United Kingdom.PloS one · 2014Article
- Article
- Antiretroviral treatment switch strategies for lowering the costs of antiretroviral therapy in subjects with suppressed HIV-1 viremia in Spain.ClinicoEconomics and outcomes research : CEOR · 2013Article
- Lower healthcare costs associated with the use of a single-pill ARV regimen in the UK, 2004-2008.PloS one · 2012Article
Corrections and comments
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Authors and funding
19 authors at 15 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo calculate use, cost and cost-effectiveness of people living with HIV (PLHIV) starting routine treatment and care before starting combination antiretroviral therapy (cART) and PLHIV starting first-line 2NRTIs+NNRTI or 2NRTIs+PI(boosted), comparing PLHIV with CD4≤200 cells/mm3 and CD4>200 cells/mm3. Few studies have calculated the use, cost and cost-effectiveness of routine treatment and care before starting cART and starting cART above and below CD4 200 cells/mm3.
methodsUse, costs and cost-effectiveness were calculated for PLHIV in routine pre-cART and starting first-line cART, comparing CD4≤200 cells/mm3 with CD4>200 cells/mm3 (2008 UK prices).
resultscART naïve patients CD4≤200 cells/mm3 had an annual cost of £6,407 (95%CI £6,382 to £6,425) PPY compared with £2,758 (95%CI £2,752 to £2,761) PPY for those with CD4>200 cells/mm3; cost per life year gained of pre-cART treatment and care for those with CD4>200 cells/mm3 was £1,776 (cost-saving to £2,752). Annual cost for starting 2NRTIs+NNRTI or 2NRTIs+PI(boosted) with CD4≤200 cells/mm3 was £12,812 (95%CI £12,685-£12,937) compared with £10,478 (95%CI £10,376-£10,581) for PLHIV with CD4>200 cells/mm3. Cost per additional life-year gained on first-line therapy for those with CD4>200 cells/mm3 was £4639 (£3,967 to £2,960).
conclusionPLHIV starting to use HIV services before CD4≤200 cells/mm3 is cost-effective and enables them to be monitored so they start cART with a CD4>200 cells/mm3, which results in better outcomes and is cost-effective. However, 25% of PLHIV accessing services continue to present with CD4≤200 cells/mm3. This highlights the need to investigate the cost-effectiveness of testing and early treatment programs for key populations in the UK.
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Registered trials
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.