ArticleThe New England journal of medicine2013
Cost-effectiveness of HIV treatment as prevention in serodiscordant couples.
Article in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
87 citing papers in PubMed, 2 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review.Health economics · 2016Pooled it
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- Trial
- Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial.The Lancet. Global health · 2017Trial
- Ending the HIV Epidemic in the United States Among Men Who Have Sex With Men: A Modeling Analysis.Open forum infectious diseases · 2026Article
- Potential long-acting tuberculosis treatment for people with HIV: cost-effectiveness benchmarks.Annals of the American Thoracic Society · 2026Article
- A call to action to advance global research priorities related to Undetectable = Untransmittable.Journal of the International AIDS Society · 2025Article
- Clinical impact and cost-effectiveness of the WHO-recommended advanced HIV disease package of care.The Lancet. Global health · 2025Article
- Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV/AIDS.Tropical medicine and infectious disease · 2025Review
- Pharmacoeconomic perspectives on HIV: integrating data for long-term treatment and prevention.Frontiers in medicine · 2025Review
- The Success of Serious Games and Gamified Systems in HIV Prevention and Care: Scoping Review.JMIR serious games · 2023Article
- A Growing Number of Men Who Have Sex With Men Aging With HIV (20212031): A Comparison of Two Microsimulation Models.The Journal of infectious diseases · 2023Article
- Nutritional Supplementation Would Be Cost-Effective for Reducing Tuberculosis Incidence and Mortality in India: The Ration Optimization to Impede Tuberculosis (ROTI-TB) Model.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Finding and treating early-stage HIV infections: A cost-effectiveness analysis of theLancet regional health. Americas · 2022Article
- Evaluation of four chemotherapy regimens for treatment of advanced AIDS-associated Kaposi sarcoma in Kenya: a cost-effectiveness analysis.The Lancet. Global health · 2022Article
- Development and validation of the age-associated dementia policy (AgeD-Pol) computer simulation model in the USA and Europe.BMJ open · 2022Article
- Cost-effectiveness of a Novel Lipoarabinomannan Test for Tuberculosis in Patients With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Health economics modeling of antiretroviral interventions amongst HIV serodiscordant couples.Scientific reports · 2021Article
- Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population.BMJ open · 2020Article
27 more citing papers are in PubMed but not listed here.
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Authors and funding
20 authors at 11 institutions in 4 countries.
Funding
Abstract
backgroundThe cost-effectiveness of early antiretroviral therapy (ART) in persons infected with human immunodeficiency virus (HIV) in serodiscordant couples is not known. Using a computer simulation of the progression of HIV infection and data from the HIV Prevention Trials Network 052 study, we projected the cost-effectiveness of early ART for such persons.
methodsFor HIV-infected partners in serodiscordant couples in South Africa and India, we compared the early initiation of ART with delayed ART. Five-year and lifetime outcomes included cumulative HIV transmissions, life-years, costs, and cost-effectiveness. We classified early ART as very cost-effective if its incremental cost-effectiveness ratio was less than the annual per capita gross domestic product (GDP; $8,100 in South Africa and $1,500 in India), as cost-effective if the ratio was less than three times the GDP, and as cost-saving if it resulted in a decrease in total costs and an increase in life-years, as compared with delayed ART.
resultsIn South Africa, early ART prevented opportunistic diseases and was cost-saving over a 5-year period; over a lifetime, it was very cost-effective ($590 per life-year saved). In India, early ART was cost-effective ($1,800 per life-year saved) over a 5-year period and very cost-effective ($530 per life-year saved) over a lifetime. In both countries, early ART prevented HIV transmission over short periods, but longer survival attenuated this effect; the main driver of life-years saved was a clinical benefit for treated patients. Early ART remained very cost-effective over a lifetime under most modeled assumptions in the two countries.
conclusionsIn South Africa, early ART was cost-saving over a 5-year period. In both South Africa and India, early ART was projected to be very cost-effective over a lifetime. With individual, public health, and economic benefits, there is a compelling case for early ART for serodiscordant couples in resource-limited settings. (Funded by the National Institute of Allergy and Infectious Diseases and others.).
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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.