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Embargo date
2050-01-01
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
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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
Brazil
Coinfection
Cost of Illness
Costs and Cost Analysis
HIV Infections
Health Services Research
Brasil / epidemiologia
Coinfecção / economia
Coinfecção / epidemiologia
Custos e Análise de Custo
Fêmea
Infecções por HIV / economia
Infecções por HIV / epidemiologia
Humanos
Renda
Tuberculose Latente / epidemiologia
Masculino
Meia idade
Adulto jovem
Author
Affilliation
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
London School of Hygiene & Tropical Medicine. Global Health and Development. London, UK.
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).
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).
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.
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.
Keywords
Latent TuberculosisBrazil
Coinfection
Cost of Illness
Costs and Cost Analysis
HIV Infections
Health Services Research
DeCS
AdultoBrasil / epidemiologia
Coinfecção / economia
Coinfecção / epidemiologia
Custos e Análise de Custo
Fêmea
Infecções por HIV / economia
Infecções por HIV / epidemiologia
Humanos
Renda
Tuberculose Latente / epidemiologia
Masculino
Meia idade
Adulto jovem
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