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Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil.

Authors :
Teixeira de Siqueira-Filha N
Militao de Albuquerque MF
Cunha Rodrigues L
Legood R
Costa Santos A
Source :
Sexually transmitted infections [Sex Transm Infect] 2018 Sep; Vol. 94 (6), pp. 463-469. Date of Electronic Publication: 2018 Mar 15.
Publication Year :
2018

Abstract

Objective: The objective of this study was to measure the costs of people living with HIV (PLHIV) as well as active tuberculosis (TB/HIV), latent tuberculosis infection (LTBI/HIV) or without TB (HIV/AIDS).<br />Methods: We analysed the costs through the entire pathway of care during the prediagnosis and treatment periods from the Brazilian public health system perspective. We applied a combination of bottom-up and top-down approaches to capture and estimate direct medical and non-medical costs. We measured the mean cost per patient per type of care (inpatient, outpatient and emergency care) and disease category (HIV/AIDS, HIV/AIDS death, TB/HIV, TB/HIV death and LTBI/HIV).<br />Results: Between March 2014 and March 2016 we recruited 239 PLHIV. During the follow-up 26 patients were diagnosed and treated for TB and 5 received chemoprophylaxis for LTBI. During the prediagnosis and treatment period, the mean total costs for HIV or AIDS and AIDS death categories were US$1558 and US$2828, respectively. The mean total costs for TB/HIV and TB/HIV death categories were US$5289.0 and US$8281, respectively. The mean total cost for the LTBI/HIV category was US$882.<br />Conclusions: Patients with TB/HIV impose a higher economic burden on the health system than HIV/AIDS and LTBI/HIV. Patients with LTBI/HIV were the lowest cost group among all disease categories, indicating that preventive TB treatment can avoid the further costs treating active TB.<br />Trial Registration Number: RBR-22t943, Results.<br />Competing Interests: Competing interests: None declared.<br /> (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Details

Language :
English
ISSN :
1472-3263
Volume :
94
Issue :
6
Database :
MEDLINE
Journal :
Sexually transmitted infections
Publication Type :
Academic Journal
Accession number :
29545471
Full Text :
https://doi.org/10.1136/sextrans-2017-053277