using a computer simulation to model HIV disease helps answer

This cost-effectiveness analysis of 3 options (no treatment and treatment initiation thresholds of 250 and 350 CD4 cell counts) using a computer simulation to model HIV disease helps answer a critical question in the South African national context. What at the clinical outcomes and costs over the short-term (5 years) of different decisions on treatment initiation, taking into account the chance that the trials currently studying antiretroviral initiation will demonstrate a clinical benefit of antiretroviral treatment initiation at the 350 cell count level? Although randomised controlled trials, rather than models, are the gold standard for developing policy, models can help inform policy. Inadequate treatment capacity may exacerbate inequities in treatment access and this should be carefully monitored regardless of CD4 count entry criteria. Changes in the WHO treatment guidelines are likely to be announced in the coming months, provoking many countries which have not done so to consider how to strengthen their strategies for scale-up to universal access