Costs of Care of HIV-Infected Children Initiating Lopinavir/Ritonavir-Based Antiretroviral Therapy before the Age of Two in Cote d’Ivoire

ObjectivesTo access the costs of care for Ivoirian children before and after initiating LPV/r-based antiretroviral therapy (ART) before the age of two.MethodsWe assessed the direct costs of care for all HIV-infected children over the first 12 months on LPV/r-based ART initiated ResultsOf the 114 children screened, 99 initiated LPV/r-based ART at a median age of 13.5 months (IQR: 6.8–18.6); 45% had reached World Health Organization stage 3 or 4. During the first 12 months on ART, 5% died and 3% were lost to follow-up. In the month before ART initiation, the mean cost of care per child-month reached $123.39 (95%CI:$121.02-$125.74). After ART initiation, it was $42.53 (95%CI:$42.15-$42.91); 50% were ART costs. The remaining costs were non-antiretroviral drugs (18%) and medical analyses/examinations (14%). Mean costs were significantly higher within the first three months on ART ($48.76, 95%CI:$47.95–$49.56) and in children experiencing severe morbidity ($49.76, 95%CI:$48.61–50.90).ConclusionART reduces the overall monthly cost of care of HIV-infected children