Table 2 Outcomes over 20 years (2015–2035) in people with HIV (age 15–65), according to monitoring strategy.
From: Sustainable HIV treatment in Africa through viral-load-informed differentiated care
No monitoring | Clinical monitoring | Clinical monitoring viral load confirmation | Clinical monitoring CD4 count confirmation | CD4 count monitoring (WHO) | CD4 count monitoring (<200) | Viral-load-informed differentiated care using DBS | |
|---|---|---|---|---|---|---|---|
Percentage of ART-experienced people who have fulfilled criterion for failure of first-line ART | 7% | 14% | 10% | 13% | 41% | 26% | 27% |
Percentage of ART-experienced people who have started second-line ART | 3% | 13% | 10% | 13% | 38% | 24% | 25% |
Percentage of people on ART who have (true) viral load <1,000 cps ml -1 (mean; over 20-year time horizon) | 76% | 79% | 78% | 79% | 85% | 82% | 86% |
Death rate (per 100 person years) among people on ART | 4.43 | 3.63 | 4.06 | 3.67 | 3.02 | 3.07 | 3.18 |
Death rate (per 100 person years) among people with HIV | 5.45 | 4.91 | 5.2 | 4.93 | 4.36 | 4.43 | 4.47 |
Death rate (per 100 person years) in the whole adult population | 1.69 | 1.63 | 1.66 | 1.63 | 1.56 | 1.58 | 1.57 |
Death rate (per 100 person years) among people on ART who have virologically failed first-line ART (regardless of whether monitoring strategy has detected it) | 9.94 | 7.5 | 8.66 | 7.62 | 5.53 | 5.79 | 5.85 |
Incidence of HIV (per 100 person years) | 0.84 | 0.81 | 0.83 | 0.81 | 0.76 | 0.79 | 0.73 |
For each model run for each strategy, the outcome of interest (as listed in the first column) is output for each 3-month period between 2015–2035. Over 500 model runs are done for each strategy, then means are taken over 3-month periods and model runs. ART, antiretroviral therapy; Cps, copies; DBS, dried blood spot; WHO, World Health Organization. | |||||||
