Over the past 11 years, the 'Cost-Effectiveness of Preventing AIDS Complications' (CEPAC) team hasexpanded and refined its computer simulation of HIV disease in order to better address critical questions inHIV management. During the first two years ofthe R37 cycle, the CEPAC project has experiencedtremendous growth, outstanding productivity, and increased outreach and collaboration with otherNIAID-funded as well as other national and international research groups. During this time, the CEPACteam has published 19 peer-reviewed papers, with one more in press and two others submitted.
The specific aims for the next cycle of the grant (2010-2015) address critical areas of HIV clinical care andpolicy in the United States, while continuing the cutting-edge methodology and applications that havemaintained the CEPAC team as an internationally-recognized HIV research effort. The three specific aimsfor the next phase of the grant are:1. To examine the issue of when to start antiretroviral therapy in the US, taking into account a newerunderstanding of HIV disease complications and new approaches to HIV testing.2. To determine the clinical impact, value and optimal use of both new diagnostic technologies and existinglaboratory monitoring tests.3. To evaluate comprehensive approaches to HIV care that will optimize treatment outcomes in the contextof improved survival, an aging population, and an increasing prevalence of co-morbidities.During the next cycle of this project, we will use innovative simulation methods and incorporate new datafrom the best national sources to deliver high-impact studies that will directly influence HIV treatmentguidelines and policies in the United States.
The long-term management of HIV disease is increasingly complicated by development of 'non-HIV'diseases and the high cost of HIV care, which includes not only medications, but also diagnostic tests andcare over many years of therapy. Disease simulation modeling and cost-effectiveness analysisareinvaluable tools for assessing the relative clinical benefits, costs and cost-effectiveness of HIV policies.
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