HIV Care in Times of COVID-19 – Rapid Treatment Start Seems as Vital and Cost-Effective Approach in Central and Eastern Europe

Abstract

\n Background: In times of SARS-CoV-2 epidemic it is essential to deliver specialist HIV care with a maximum effectiveness, but minimum epidemiological risk. Therefore, we aimed to determine whether rapid linkage tocare definedas starting combined antiretroviral therapy (cART) at the day of first visit in HIV clinic is a cost-effective approach.Methods:The analysis used Markov s lifetime model presented in our previous study. The input data used in the model were updated in terms of costs, life expectancy tables and patient’s characteristics. This analysis used information from the previous model about the additional cost of treatment and QALY lost in the life horizon for people newly infected with HIV. Number of new infected persons was estimated on the basis of available data.Results:Input data were available for 344 MSM patients who registered in HIV specialist care between 2016 and 2017. Estimated QALY loss due to no rapid treatmentin case of no taking (taking) into account viral load equal 0·018 (0·022), 0·039 (0·047), 0·131 (0·158) respectively in low, medium and high-risk transmission groups. RapidcART initiation was dominant regardless of the chosenscenarios. Conclusions:Taking into account HIV transmission in cost–effectiveness analysis indicates that rapid-initiation of HIV treatment is profitable.