Antiretroviral therapy for HIV infection in patients naive to prior treatment: a systematic review of effectiveness and cost-effectiveness

Jordan R, Gold L, Hyde C, Cummins C
Record ID 32011000106
English
Authors' objectives:

The aim of this study is to produce a systematic review with a meta-analysis of the effectiveness of antiretroviral therapy in HIV positive patients who have not had prior treatment, and also provide an evaluation of the available economic analyses. Patients naïve to prior therapy are selected in order to avoid potential dilution of the effects in patients with established drug-resistance.

Authors' recommendations: All the disease outcomes (CD4 count, viral load and disease progression/death) are consistent with triple therapy > double therapy > monotherapy > no treatment (data for quadruple therapy was too limited to conclude this). Commissioners should be reassured that treatment policy has been justified so far, but should be aware that more evidence is needed to examine the effectiveness of individual drug combinations and additions before endorsing larger numbers of drugs. Cost-effectiveness studies will always be difficult to interpret if short term data are used. High quality longer term cohort studies will be required to evaluate life-time costs and effects.
Details
Project Status: Completed
Year Published: 2000
URL for published report: http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/WMHTAC/REPreports/2000/HIV.pdf
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Acquired Immunodeficiency Syndrome
  • Anti-HIV Agents
  • Antiretroviral Therapy, Highly Active
  • Costs and Cost Analysis
Contact
Organisation Name: West Midlands Health Technology Assessment Collaboration
Contact Address: Elaena Donald-Lopez, West Midlands Health Technology Assessment Collaboration, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT Tel: +44 121 414 7450; Fax: +44 121 414 7878
Contact Name: louise.a.taylor@bham.ac.uk
Contact Email: louise.a.taylor@bham.ac.uk
Copyright: <p>West Midlands Health Technology Assessment Collaboration (WMHTAC)</p>
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