Table 3.

Cost-effectiveness of POC routine viral load monitoring compared to CD4 or clinical monitoring in three scenarios.

	Unit cost of viral load test (US$)	CD4 monitoring	POC viral load monitoring LOD (copies/ml):
			1 000	5 000	10 000
Scenario A
Compared to CD4 monitoring	5	n/a	8010	6430	5960
	10	n/a	13860	12230	11740
	20	n/a	25540	23830	23340
Compared to clinical monitoring	5	3300	4560	4140	4010
	10	3300	6120	5690	5550
	20	3300	9230	8780	8650
Scenario B
Compared to CD4 monitoring	5	n/a	3010	2340	2230
	10	n/a	5470	4780	4740
	20	n/a	10380	9670	9790
Compared to clinical monitoring	5	2590	2760	2490	2450
	10	2590	3790	3500	3470
	20	2590	5830	5530	5520
Scenario C
Compared to CD4 monitoring	5	n/a	c/s	c/s	c/s
	10	n/a	760	520	460
	20	n/a	2460	2210	2170
Compared to clinical monitoring	5	2540	1110	990	960
	10	2540	1570	1440	1420
	20	2540	2500	2360	2340

Cost-effectiveness is presented as incremental cost-effectiveness ratio (US$/quality adjusted life year) with 3% annual discounting. Cost-effectiveness of CD4 versus clinical monitoring is also shown.

POC, point-of-care; LOD, limit of detection; n/a, not applicable; c/s, cost-saving Scenario A (equal failure rates, HIV transmission not considered), Scenario B (equal failure rates, HIV transmission considered) and Scenario C (true treatment failure rate twice as high with CD4 or clinical compared to viral load monitoring, HIV transmission considered).