Table 1.
Life expectancy expressed as life-years and quality-adjusted life-years (QALYs) with different antiretroviral therapy initiation thresholds, stratified by proportion of antiretroviral doses taken as directed, assuming minimal toxicity from antiretroviral therapy and with upper-bound estimate for antiretroviral toxicity.
| Toxicity assumptions, adherence, age |
Life-years, by CD4+ cell count at therapy initiation |
QALYs, by CD4+ cell count at therapy initiation |
||||
|---|---|---|---|---|---|---|
| 200 cells/µL | 350 cells/µL | 500 cells/µL | 200 cells/µL | 350 cells/µL | 500 cells/µL | |
| Minimal toxicity assumptions | ||||||
| 50% | ||||||
| 30 years | 19.3 | 23.3 | 26.7 | 16.4 | 20.0 | 23.1 |
| 40 years | 15.7 | 18.8 | 21.4 | 13.4 | 16.2 | 18.5 |
| 50 years | 13.1 | 15.4 | 17.2 | 11.3 | 13.3 | 14.9 |
| 60% | ||||||
| 30 years | 20.1 | 23.7 | 27.2 | 17.0 | 20.3 | 23.5 |
| 40 years | 16.5 | 19.4 | 21.9 | 14.2 | 16.7 | 19.0 |
| 50 years | 13.8 | 15.9 | 17.6 | 11.9 | 13.8 | 15.3 |
| 70% | ||||||
| 30 years | 21.1 | 24.7 | 27.7 | 18.0 | 21.3 | 24.0 |
| 40 years | 17.6 | 20.3 | 22.6 | 15.1 | 17.6 | 19.6 |
| 50 years | 14.7 | 16.6 | 18.1 | 12.7 | 14.4 | 15.8 |
| 80% | ||||||
| 30 years | 22.8 | 26.0 | 28.7 | 19.5 | 22.5 | 25.0 |
| 40 years | 19.0 | 21.6 | 23.5 | 16.4 | 18.8 | 20.5 |
| 50 years | 15.6 | 17.5 | 18.8 | 13.6 | 15.3 | 16.5 |
| 90% | ||||||
| 30 years | 25.4 | 28.4 | 30.6 | 21.9 | 24.7 | 26.7 |
| 40 years | 21.0 | 23.3 | 25.0 | 18.3 | 20.4 | 21.9 |
| 50 years | 16.9 | 18.6 | 19.8 | 14.8 | 16.4 | 17.4 |
| 100% | ||||||
| 30 years | 29.8 | 32.2 | 33.5 | 26.2 | 28.4 | 29.5 |
| 40 years | 24.0 | 25.8 | 26.6 | 21.2 | 22.8 | 23.5 |
| 50 years | 18.6 | 19.8 | 20.6 | 16.5 | 17.6 | 18.2 |
| Upper-bound toxicity assumptions | ||||||
| 50% | ||||||
| 30 years | 14.5 | 15.5 | 16.4 | 12.4 | 13.6 | 14.2 |
| 40 years | 11.3 | 11.7 | 11.9 | 9.8 | 10.1 | 10.4 |
| 50 years | 8.9 | 8.9 | 8.8 | 7.8 | 7.8 | 7.7 |
| 60% | ||||||
| 30 years | 15.0 | 15.9 | 16.7 | 12.9 | 13.7 | 14.5 |
| 40 years | 11.7 | 12.0 | 12.2 | 10.2 | 10.4 | 10.6 |
| 50 years | 9.1 | 9.0 | 8.9 | 8.0 | 7.9 | 7.8 |
| 70% | ||||||
| 30 years | 15.6 | 16.4 | 17.0 | 13.4 | 14.3 | 14.8 |
| 40 years | 12.1 | 12.3 | 12.4 | 10.6 | 10.8 | 10.8 |
| 50 years | 9.3 | 9.3 | 9.0 | 8.3 | 8.2 | 8.0 |
| 80% | ||||||
| 30 years | 16.3 | 17.0 | 17.4 | 14.1 | 14.9 | 15.2 |
| 40 years | 12.5 | 12.8 | 12.7 | 11.0 | 11.3 | 11.1 |
| 50 years | 9.6 | 9.4 | 9.1 | 8.5 | 8.4 | 8.1 |
| 90% | ||||||
| 30 years | 17.1 | 17.6 | 18.0 | 15.0 | 15.5 | 15.9 |
| 40 years | 13.1 | 13.1 | 13.0 | 11.6 | 11.6 | 11.5 |
| 50 years | 9.8 | 9.6 | 9.3 | 8.8 | 8.5 | 8.2 |
| 100% | ||||||
| 30 years | 18.1 | 18.5 | 18.6 | 16.1 | 16.4 | 16.5 |
| 40 years | 13.5 | 13.5 | 13.2 | 12.1 | 12.0 | 11.7 |
| 50 years | 10.0 | 9.7 | 9.4 | 9.0 | 8.7 | 8.3 |
NOTE. The upper-bound estimate for antiretroviral toxicity confers a strong bias against earlier treatment initiation. Results shown are for viral loads of 100,000 copies/mL; lower viral loads modestly reduced the amount of benefit from earlier treatment initiation. Boldface type indicates the most favored initiation strategy.