Scaling Up the 2010 World Health Organization HIV Treatment Guidelines in Resource-Limited Settings A Model-Based Analysis 英文参考文献.docVIP

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Scaling Up the 2010 World Health Organization HIV Treatment Guidelines in Resource-Limited Settings A Model-Based Analysis 英文参考文献.doc

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Scaling Up the 2010 World Health Organization HIV Treatment Guidelines in Resource-Limited Settings A Model-Based Analysis 英文参考文献

ScalingUpthe2010WorldHealthOrganizationHIV TreatmentGuidelinesinResource-LimitedSettings:A Model-BasedAnalysis RochelleP.Walensky1,2,3,4*,RobinWood6,AndreaL.Ciaranello1,A.DavidPaltiel7,SarahB.Lorenzana2, XavierAnglaret8,9,AdamW.Stoler2,KennethA.Freedberg1,2,4,5,fortheCEPAC-International Investigators 1Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 2Division of General Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 3Division of Infectious Disease, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America, 4Harvard University Center for AIDS Research, Harvard Institute for Global Health, Cambridge, Massachusetts, United States of America, 5Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, United States of America, 6Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa, 7Yale School of Medicine, New Haven, Connecticut, United States of America, 8INSERM Unite′ 897, Centre de Recherche ‘‘Epide′miologie et Biostatistique’’, Bordeaux Cedex, France, 9Universite′ VictorSegalenBordeaux2,Bordeaux,France Abstract Background:Thenew2010WorldHealthOrganization(WHO)HIVtreatmentguidelinesrecommendearlierantiretroviral therapy(ART)initiation(CD4,350cells/mlinsteadofCD4,200cells/ml),multiplesequentialARTregimens,andreplacement of first-line stavudine with tenofovir. This paper considers what to do first in resource-limited settings where immediate implementationofalloftheWHOrecommendationsisnotfeasible. MethodsandFindings:Weuseamathematicalmodelandlocalinputdatatoprojectclinicalandeconomicoutcomesina SouthAfricanHIV-infectedcohort(meanage=32.8y,meanCD4=375/ml).Forthereferencestrategy,weassumethatall patientsinitiatestavudine-basedARTwithWHOstageIII/IVdiseaseandreceiveonelineofART(stav