Effect of eliminating CD4-count thresholds on HIV treatment initiation in South Africa: An empirical modeling study.

ABSTRACT:

Background

The World Health Organization recommends initiating antiretroviral therapy (ART) regardless of CD4 count. We assessed the effect of ART eligibility on treatment uptake and simulated the impact of WHO's recommendations in South Africa.

Methods

We conducted an empirical analysis of cohort data using a regression discontinuity design, and then used this model for policy simulation. We enrolled all patients (n = 19,279) diagnosed with HIV between August 2011 and December 2013 in the Hlabisa HIV Treatment and Care Programme in rural South Africa. Patients were ART-eligible with CD4<350 cells/mm3 or Stage III/IV illness. We estimated: (1) distribution of first CD4 counts in 2013; (2) probability of initiating ART ≤6 months of HIV diagnosis under existing criteria at eac

SUBMITTER: Bor J 

PROVIDER: S-EPMC5472329 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature