Evaluation of epidemiological and economic consequences due to the delay in treatment of hiv-positive patients caused by the covid-19 pandemic


  • Andrea Marcellusi Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy and Institute for Leadership and Management in Health – Kingston University London, London - UK https://orcid.org/0000-0002-3974-3798
  • Chiara Bini Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy
  • Massimo Andreoni University of Tor Vergata, Rome - Italy
  • Andrea Antinori National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome - Italy
  • Francesco Saverio Mennini Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy and Institute for Leadership and Management in Health – Kingston University London, London - UK




Acquired Immunodeficiency Syndrome Virus, Coronavirus Disease, COVID-19 Pandemic, Human immunodeficiency virus


Objective: To assess, from an epidemiological and economic point of view, the consequences of the reduction in the supply of antiretroviral drugs due to the COVID-19 pandemic.

Method: The analysis was conducted by adapting a Markov model previously published in literature. The simulations were conducted considering the possibility of continuous treatment for patients already diagnosed (no therapeutic interruptions are expected) and an immediate start of patients with new diagnosis during 2021. This analysis was compared with a scenario involving a therapeutic interruption or diagnostic delay caused by COVID-19.

Results: The analysis showed that the scenario characterized by a treatment delay, compared to the scenario of early resumption of therapy, could generate an increase in the number of patients with CD4 < 200 equal to 1,719 subjects (+16%) and a reduction in the number of patients with CD4 500 equal to 6,751 (−9%). A timely resumption of treatment for HIV+ patients could prevent 296, 454 and 687 deaths in the third, fifth and tenth years of analysis respectively with a potential cost reduction equal to 78,9 million at a 10 year time horizon.

Conclusions: These findings show that it is essential, especially in a pandemic situation such as the present one, to introduce technological, digital and organizational solutions, aimed at promoting timely diagnosis and at accelerating the therapeutic switch for patients who are no longer targeted.


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Marcellusi A, Bini C, Andreoni M, Antinori A, Mennini FS. Evaluation of epidemiological and economic consequences due to the delay in treatment of hiv-positive patients caused by the covid-19 pandemic. Grhta [Internet]. 2021 Oct. 25 [cited 2021 Dec. 7];8:147-54. Available from: https://journals.aboutscience.eu/index.php/grhta/article/view/2279



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