The Impact of the New WHO Antiretroviral Treatment Guidelines on HIV Epidemic Dynamics and Cost in South Africa
Figure 4
Projected net cost and life-years saved of implementing the new WHO treatment guidelines (ART at CD4+ cell counts of ≤350 /µl) versus the old treatment guidelines (ART at CD4+ cell counts of ≤200 cells/µl) in the Hlabisa subdistrict of the Umkhanyakunde District, KwaZulu/Natal, South Africa, 2010–2040.
A. Cumulative net cost of treating patients at ≤350 cells/µl compared to ≤200 cells/µl. Negative values reflect net cost-savings. B. Cumulative number of life-years saved when treating patients at ≤350 cells/µl compared to ≤200 cells/µl. The black continuous line shows the average of 1000 model runs. Grey lines represent 50 individual runs to illustrate the random variation in model output. Both dotted black lines represent the results for increased and decreased levels of endemicity, when assuming a 10% higher and 10% lower overall partner change rate respectively (see also figure 1D). The blue line represents the results of treating patients at ≤350 cells/µl versus a strategy of treating patients at ≤200 cells/µl, together with 19% of patients that report with CD4+ of 201–350 cells/µl. This 19% is a crude estimation of the proportion of pregnant women and TB co-infected patients among HIV-patients with CD4+ of 201–350, who are since recently eligible to receive ART under the current South African strategy.