The impact of British and US guidelines for initiating combination antiretroviral therapy on estimating national treatment requirements for HIV-positive patients

Abstract

This paper uses comprehensive national data on HIV positive patients in Scotland to carry out a needs assessment exercise for combination antiretroviral therapy. The objective of this study was to estimate the numbers of HIV positive patients in Scotland who would be eligible for combination antiretroviral therapy under current British and US guidelines and to demonstrate the impact of these different guidelines on the resources required. The proportion of the Scottish population that would be eligible for combination therapy ranged from 76% to 91%, under different guidelines for initiating therapy. We thus estimate that for countries such as Scotland, including western Europe and the United States, where a large proportion of the HIV population became infected in the early to mid-1980s, the majority of patients will be eligible for combination therapy, regardless of the guideline.