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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.
- 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.)
- Subjects :
- Adult
Brazil epidemiology
Coinfection epidemiology
Cost of Illness
Costs and Cost Analysis
Female
HIV Infections epidemiology
Health Services Research
Humans
Income
Latent Tuberculosis epidemiology
Male
Mass Screening
Middle Aged
Young Adult
Coinfection economics
HIV Infections economics
Latent Tuberculosis economics
Subjects
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