Cost-utility analysis

Introduction: This study aims to establish the costs and effectiveness of antiretroviral therapy (ART) for HIV positive adults in a resource-constrained public-sector setting. The research compares ART to the current status quo for HIV-positive adults who are dependent on the public sector for care in South Africa i.e the treatment of opportunistic and HIV- elated infections and events (e.g. wasting) in the absence of ART. This research is clearly important in the developing country context, where the HIV epidemic is expected to have a dramatic impact on life expectancy and to lead to early mortality for a large proportion of the population (Dorrington, Bourne et al. 2001). This study presents the first cost-effectiveness results derived from a public sector clinic-based treatment programme. Cost, effectiveness and quality of life data have been collected from a single cohort receiving care in three HIV-dedicated clinics in Khayelitsha, a township on the outskirts of Cape Town. This setting is similar to what will be encountered in the public sector ART rollout.