Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy

Highly active antiretroviral therapy (HAART) has been recommended for human immunodeficiency virus (HIV)-positive patients with a detectable viral loa d; it typically consists of two reverse transcriptase inhibitors combined w ith a protease inhibitor. In 1996, Madigan Army Medical Center began offeri ng HAART to HIV-positive patients with a detectable viral load. We retrospe ctively reviewed the records of our HIV patients before and after the initi ation of HAART to determine the impact of HAART on hospitalizations, mortal ity, and outpatient pharmacy expenditures, Comparing 1997 with 1994 and 199 5, we found a greater than 700% increase in the average expenditure on anti retroviral agents after institution of HAART, At the same time, we found a dramatic reduction in hospitalizations and nontraumatic mortality. Therefor e, the increase in expenditures on antiretroviral agents may be offset by a reduction in hospitalizations and mortality.