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Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand

หน่วยงาน มหาวิทยาลัยเชียงใหม่

รายละเอียด

ชื่อเรื่อง : Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand
นักวิจัย : Collins I.J. , Cairns J. , Ngo-Giang-Huong N. , Sirirungsi W. , Leechanachai P. , Coeur S.L. , Samleerat T. , Kamonpakorn N. , Mekmullica J. , Jourdain G. , Lallemant M.
คำค้น : -
หน่วยงาน : มหาวิทยาลัยเชียงใหม่
ผู้ร่วมงาน : -
ปีพิมพ์ : 2557
อ้างอิง : 19326203 , 10.1371/journal.pone.0091004 , POLNC , http://www.scopus.com/inward/record.url?eid=2-s2.0-84898471383&partnerID=40&md5=68e0e3b0c5781739f0752f2e6010397d , http://cmuir.cmu.ac.th/handle/6653943832/693
ที่มา : -
ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : -
บทคัดย่อ/คำอธิบาย :

Background: HIV-infected infants have high risk of death in the first two years of life if untreated. WHO guidelines recommend early infant HIV diagnosis (EID) of all HIV-exposed infants and immediate antiretroviral therapy (ART) in HIV-infected children under 24-months. We assessed the cost-effectiveness of this strategy in HIV-exposed non-breastfed children in Thailand. Methods: A decision analytic model of HIV diagnosis and disease progression compared: EID using DNA PCR with immediate ART (Early-Early); or EID with deferred ART based on immune/clinical criteria (Early-Late); vs. clinical/serology based diagnosis and deferred ART (Reference). The model was populated with survival and cost data from a Thai observational cohort and the literature. Incremental cost-effectiveness ratio per life-year gained (LYG) was compared against the Reference strategy. Costs and outcomes were discounted at 3%. Results: Mean discounted life expectancy of HIV-infected children increased from 13.3 years in the Reference strategy to 14.3 in the Early-Late and 17.8 years in Early-Early strategies. The mean discounted lifetime cost was $17,335, $22,583 and $29,108, respectively. The cost-effectiveness ratio of Early-Late and Early-Early strategies was $5,149 and $2,615 per LYG, respectively as compared to the Reference strategy. The Early-Early strategy was most cost-effective at approximately half the domestic product per capita per LYG ($ 4,420 in Thailand 2011). The results were robust in deterministic and probabilistic sensitivity analyses including varying perinatal transmission rates. Conclusion: In Thailand, EID and immediate ART would lead to major survival benefits and is cost- effective. These findings strongly support the adoption of WHO recommendations as routine care. © 2014 Collins et al.

บรรณานุกรม :
Collins I.J. , Cairns J. , Ngo-Giang-Huong N. , Sirirungsi W. , Leechanachai P. , Coeur S.L. , Samleerat T. , Kamonpakorn N. , Mekmullica J. , Jourdain G. , Lallemant M. . (2557). Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand.
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Collins I.J. , Cairns J. , Ngo-Giang-Huong N. , Sirirungsi W. , Leechanachai P. , Coeur S.L. , Samleerat T. , Kamonpakorn N. , Mekmullica J. , Jourdain G. , Lallemant M. . 2557. "Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand".
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Collins I.J. , Cairns J. , Ngo-Giang-Huong N. , Sirirungsi W. , Leechanachai P. , Coeur S.L. , Samleerat T. , Kamonpakorn N. , Mekmullica J. , Jourdain G. , Lallemant M. . "Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand."
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ , 2557. Print.
Collins I.J. , Cairns J. , Ngo-Giang-Huong N. , Sirirungsi W. , Leechanachai P. , Coeur S.L. , Samleerat T. , Kamonpakorn N. , Mekmullica J. , Jourdain G. , Lallemant M. . Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand. เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ ; 2557.