ArticleBMC infectious diseases2025
INSTIs-centered antiviral regimens for first-line treatment of HIV/AIDS: a network meta-analysis and cost-effectiveness analysis.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy and safety of TDF+3TC + EFV‑centric antiretroviral regimens for HIV/HBV co-infection: a systematic review and network meta‑analysis.BMC infectious diseases · 2026Pooled it
- Pooled it
- Evolution of ART Medication Adherence Support and Monitoring Across IeDEA Sites: Results From Three Waves of Consortium-Wide Site Assessment Surveys, 2017, 2020 and 2023.Journal of the International AIDS Society · 2026Article
- Mucosal and systemic immune signatures reveal compartmentalized regulation of gut barrier integrity in virologically suppressed HIV Infection.Frontiers in immunology · 2026Article
- Adjunctive albuvirtide is associated with improved immune recovery in treatment-naive patients with advanced HIV disease receiving bictegravir/emtricitabine/tenofovir alafenamide: a retrospective propensity score-matched cohort study.Frontiers in immunology · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveThis study evaluates the efficacy, safety, and cost-effectiveness of INSTI-based antiretroviral regimens compared to the national standard first-line treatment EFV/3TC/TDF for HIV/AIDS in China. The aim is to guide clinical decision-making and improve HIV/AIDS prevention and treatment.
methodsA network meta-analysis was conducted using ADDIS software on data from domestic and international randomized controlled trials comparing INSTI-based regimens with EFV/3 TC/TDF. Additionally, a Markov model assessed the cost-effectiveness of the representative INSTI regimen B/F/TAF (Bictegravir/Emtricitabine/Tenofovir Alafenamide) against EFV/3 TC/TDF. Costs and health outcomes were measured in US Dollars ($) and Quality-Adjusted Life Years (QALYs), respectively, evaluating incremental cost-utility ratios (ICERs) against a willingness-to-pay threshold of 1.5 times GDP per capita.
resultsSeventeen trials involving 12,620 patients were analyzed. INSTI regimens showed no significant efficacy or safety advantages over EFV/3 TC/TDF but offered better drug resistance, adherence, and quality of life improvements. Economic analysis from the patient perspective showed that B/F/TAF had an ICER of $12,714.29/QALY, which is below the willingness-to-pay threshold, indicating cost-effectiveness. From the healthcare system perspective, B/F/TAF's ICER was $23,052.77/QALY, which is above the threshold, suggesting it is not cost-effective from this perspective. Sensitivity analyses confirmed these findings, with drug costs for B/F/TAF and the probability of CD4 count increase post-EFV/3TC/TDF treatment being the largest influencing factors. Additionally, probabilistic sensitivity analysis indicated that B/F/TAF has a varying probability of economic viability depending on the willingness-to-pay threshold, highlighting its potential value in specific economic contexts.
conclusionINSTI-based regimens are as effective and safe as the national standard but offer additional benefits in drug resistance and patient compliance. B/F/TAF is economically viable from the patient perspective but does not present a cost-utility advantage from the healthcare system perspective. This study underscores the need for considering both clinical and economic factors in selecting first-line HIV/AIDS treatments in China.
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