Many HIV‐positive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhanced‐prophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the cost‐effectiveness of this enhanced‐prophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count.

中文翻译：

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在非洲开始治疗的晚期艾滋病毒患者预防策略的成本效益


非洲许多艾滋病毒阳性者在开始抗逆转录病毒治疗（ART）时已处于晚期疾病，因此机会性感染和死亡的风险很高。 REALITY 试验发现，对于开始 ART 且 CD4 <100 个细胞/mm3 的个体，包括氟康唑在内的强化预防方案可将死亡率降低 27%。我们在 ART 开始时 CD4 <200 个细胞/mm3 或 <100 个细胞/mm3 的个体以及所有个体（无论 CD4 计数如何）中研究了这种增强预防方案与其他策略（包括使用隐球菌抗原 (CrAg) 检测）的成本效益。