December 24, 2010
"In cases where the simultaneous implementation of all components of the 2010 WHO ART guidelines is beyond the reach of programs or countries, important prioritization questions emerge," write the authors of a PLoS Medicine Article. Based on analysis of "a mathematical model and local input data to project clinical and economic outcomes in a South African HIV-infected cohort," the authors report, that "CD4 count monitoring and ART initiation at CD4<350 cells/µl are the critical initial priorities. Replacing stavudine with tenofovir would further increase survival and would also be cost-effective. Adding a second-line ART regimen would provide large survival benefits, but with substantial increases in the necessary budgets" (Walensky et al., 12/21).