Jan A. C. Hontelez (
Jacob Bor is an assistant professor in the Departments of Global Health and Epidemiology, Boston University School of Public Health, in Massachusetts.
Health Aff (Millwood). 2018 Jun;37(6):997-1004. doi: 10.1377/hlthaff.2017.0820.
The effect of HIV treatment on hospitalization rates for HIV-infected people has never been established. We quantified this effect in a rural South African community for the period 2009-13. We linked clinical data on HIV treatment start dates for more than 2,000 patients receiving care in the public-sector treatment program with five years of longitudinal data on self-reported hospitalizations from a community-based population cohort of more than 100,000 adults. Hospitalization rates peaked during the first year of treatment and were about five times higher, compared to hospitalization rates after four years on treatment. Earlier treatment initiation could save more than US$300,000 per 1,000 patients over the first four years of HIV treatment, freeing up scarce resources. Future studies on the cost-effectiveness of HIV treatment should include these effects.
HIV 治疗对感染 HIV 人群的住院率的影响从未被确定过。我们在南非农村社区对这一影响进行了量化，时间范围为 2009 年至 2013 年。我们将 2000 多名在公共部门治疗项目中接受治疗的患者的 HIV 治疗开始日期的临床数据与超过 10 万名成年人的社区为基础的人群队列的五年纵向自我报告的住院数据进行了关联。住院率在治疗的第一年达到峰值，与治疗四年后的住院率相比，高出约五倍。提前开始治疗可以在 HIV 治疗的头四年为每 1000 名患者节省超过 30 万美元，从而释放出稀缺资源。未来关于 HIV 治疗成本效益的研究应包括这些影响。
