Widespread early treatment of HIV has expanded life expectancies, prevented massive numbers of new HIV cases and saved billions of dollars in skirted life expectancy losses. Two new papers address the manifold benefits of early antiretroviral (ARV) treatment in the March issue of Health Affairs, which features various papers about HIV.

One study, out of the University of Southern California (USC), found that, between 1996 and 2009, early treatment of HIV prevented 188,700 new cases of the virus in the United States (by suppressing viral load, making those taking ARVs vastly less likely to pass on HIV) and sidestepped $128 billion in life expectancy losses. Those who started treatment with a CD4 count greater than 500 accounted for 80 percent of the prevented cases of HIV.

Another USC study found that those who started ARVs with CD4s between 350 and 500 gained an average of 6.1 years of life expectancy, while those who started treatment with greater than 500 CD4 cells gained 9 years of life expectancy. Valuing each life year at $150,000, the investigators calculated that early treatment yielded an economic benefit of $80 billion between 1996 and 2009.

The second study found that those who start treatment later have a much higher risk of dying. Compared with those who begin ARVs with between 350 and 500 CD4s, the late starters had a 28 percent higher mortality risk. Compared with those who begin treatment with greater than 500 CD4s, those who start late have a 116 percent greater risk of dying.  

Those who started treatment the earliest could expect 40 subsequent years of life.

Yet another USC study projected that by 2017 an additional 466,153 people will be tested for HIV because of the ACA, and that 2,598 new cases will be identified. The ACA is likely to shave down the number of people who are unaware of their HIV infection by 22 percent. If all states were to expand their Medicaid programs, this effect could grow by 30 percent.

To read the abstract of the study concerning prevented cases of HIV, click here.

To read the abstract of the life expectancy study, click here.

To read the abstract of the study about the effects of the ACA, click here.

To access various other Health Affairs abstracts about HIV, click here.