Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Hoenigl, M; Graff-Zivin, J; Little, SJ.
Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms.
Clin Infect Dis. 2016; 62(4):501-511
Doi: 10.1093/cid/civ912
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- Hönigl Martin
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- Abstract:
- In nonhealthcare settings, widespread screening for acute human immunodeficiency virus (HIV) infection (AHI) is limited by cost and decision algorithms to better prioritize use of resources. Comparative cost analyses for available strategies are lacking. To determine cost-effectiveness of community-based testing strategies, we evaluated annual costs of 3 algorithms that detect AHI based on HIV nucleic acid amplification testing (EarlyTest algorithm) or on HIV p24 antigen (Ag) detection via Architect (Architect algorithm) or Determine (Determine algorithm) as well as 1 algorithm that relies on HIV antibody testing alone (Antibody algorithm). The cost model used data on men who have sex with men (MSM) undergoing community-based AHI screening in San Diego, California. Incremental cost-effectiveness ratios (ICERs) per diagnosis of AHI were calculated for programs with HIV prevalence rates between 0.1% and 2.9%. Among MSM in San Diego, EarlyTest was cost-savings (ie, ICERs per AHI diagnosis less than $13.000) when compared with the 3 other algorithms. Cost analyses relative to regional HIV prevalence showed that EarlyTest was cost-effective (ie, ICERs less than $69.547) for similar populations of MSM with an HIV prevalence rate >0.4%; Architect was the second best alternative for HIV prevalence rates >0.6%. Identification of AHI by the dual EarlyTest screening algorithm is likely to be cost-effective not only among at-risk MSM in San Diego but also among similar populations of MSM with HIV prevalence rates >0.4%. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
- Find related publications in this database (using NLM MeSH Indexing)
- Algorithms -
- California -
- Cohort Studies -
- Costs and Cost Analysis -
- Early Diagnosis -
- HIV - isolation & purification
- HIV Infections - diagnosis
- Homosexuality, Male -
- Humans -
- Immunoassay - economics
- Immunoassay - methods
- Male -
- Mass Screening - economics
- Mass Screening - methods
- Mass Screening - organization & administration
- Molecular Diagnostic Techniques - economics
- Molecular Diagnostic Techniques - methods
- Find related publications in this database (Keywords)
- acute HIV
- MSM
- testing
- cost analysis
- NAT