Nicole G. Campos from Harvard University, Cambridge, Massachusetts and colleagues used data from recent clinical trials to investigate the potential health benefits, economic costs, and cost effectiveness of treatment for HCV among patients coinfected with stable HIV disease.

Average lifetime costs of treatment were $240,300, the authors report, which translated into an incremental cost effectiveness ratio, compared with no treatment, of $73,000 per year of life saved for men with genotype 1 and $39,700 per year of life saved for men with other genotypes.

The incremental cost effectiveness was more favorable (19% lower in men with genotype 1 and 17% lower in men with other genotypes) when treatment was discontinued if no early virologic response occurred, the report indicates.

The results for women were very similar to those for men, the researchers note.

"Combination therapy with pegylated interferon and ribavirin was the most effective and cost-effective treatment strategy regardless of genotype or sex," Dr. Campos and her associates write.

"As treatment-eligible coinfected patients are not currently the norm, further studies are needed to establish the effectiveness of combination HCV therapy in populations with low eligibility for treatment," the authors conclude. "For coinfected patients with stable HIV disease, treatment appears to be not only life-prolonging but cost-effective as well."

Am J Med 2007;120:272-279.

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