Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : The net cost of incorporating resistance testing into HIV/AIDS treatment in South Africa: a Markov model with primary data | Rosen et al. Journal of the International AIDS Society 2011 14 24 http content 14 1 24 JOURNALOF THE INTERNATIONAL AIDS SOCIETY RESEARCH Open Access The net cost of incorporating resistance testing into HIV AIDS treatment in South Africa a Markov model with primary data Sydney Rosen1 2 3 Lawrence Long2 3 Ian Sanne2 3 Wendy S Stevens4 5 and Matthew P Fox1 2 3 6 Abstract Background Current guidelines for providing antiretroviral therapy ART in South Africa s public sector programme call for switching patients from first-line to second-line treatment upon virologic failure as indicated by two consecutive viral loads above 5000 copies ml but without laboratory evidence of viral resistance. We modelled the net cost of adding resistance testing for patients with virological failure and retaining patients without resistance on first-line therapy rather than switching all failures to second-line therapy. Methods Costs were estimated for three scenarios routine maintenance standard care without resistance testing switch all failures to second line resistance testing resistance test for patients with failure switch those with resistance and limited testing resistance test for patients with failure in the first three years switch those with resistance . A Markov model was used to estimate the cost of each arm over five years after first line initiation. Rates of treatment failure viral resistance and treatment costs were estimated with primary data from a large HIV treatment cohort at a public facility in Johannesburg. Future costs were discounted at 3 . Results Virological failure rates over five years were in routine maintenance and in resistance testing and limited testing and of failures in routine and limited testing respectively did not have any resistance mutations resulting in and fewer patients switching to second-line ART by the end of five years. Treatment costs were estimated at US 526 and 1268 per patient per year on
