This study attempted to evaluate several HIV treatment monitoring strategies based on the 2013 and 2016 WHO Guidelines by developing a mathematical model that mimics the natural history of people on ART in South Africa. The results indicate that, from both a public health and an economic perspective, the replacement of HIV monitoring from the current CD4 count testing to only viral load (VL) testing, is not supported. The best economic results were achieved in the hybrid strategies combining CD4 and VL tests. More cost modelling studies are required to evaluate the cost-benefit of the 2016 WHO Guidelines.
Initiation of antiretroviral treatment (ART) is guided by a CD4 count and the current WHO guidelines recommend a CD4 count of 350 cells/mm3 as the threshold. In resource poor settings, traditional flow cytometric CD4 counting facilities are not widely available due to high costs and the infrastructure required. In these cases they rely on clinical Read More