The cost-effectiveness of preventing AIDS-related opportunistic infections.
Context. - Multiple options are now available for prophylaxis of opportunistic infections related to the acquired immunodeficiency syndrome (AIDS).
However, because of differences in incidence rates as well as drug efficacy, toxicity, and costs, the role of different types of prophylaxis remains uncertain.
- To determine the clinical impact, cost, and cost-effectiveness of strategies for preventing opportunistic infections in patients with advanced human immunodeficiency virus (HIV) disease.
- We developed a Markov simulation model to compare different strategies for prophylaxis of Pneumocystis carinii pneumonia (PCP), toxoplasmosis, Mycobacterium avium complex (MAC) infection, fungal infections, and cytomegalovirus (CMV) disease in HIV-infected patients.
Data for the model were derived from the Multicenter AIDS Cohort Study, randomized controlled trials, and the national AIDS Cost and Services Utilization Survey.
Main Outcome Measures
- Projected life expectancy, quality-adjusted life expectancy, total lifetime direct medical costs, and cost-effectiveness in dollars per quality-adjusted life-year (QALY) saved.
- For patients with CD4 cell counts of 0.200 to 0.300x 109/L (200-300/muL) who receive no prophylaxis, we projected a quality-adjusted life expectancy of 39.08 months and average total lifetime costs of $40 288.
Prophylaxis for PCP and toxoplasmosis with trimethoprim-sulfamethoxazole for patients with CD4 cell counts of 0. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Infection opportuniste, Pneumocystis carinii, Fungi Imperfecti, Fungi, Thallophyta, Mycobacterium avium, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bactérie, Cytomegalovirus, Betaherpesvirinae, Herpesviridae, Virus, Toxoplasmose, Protozoose, Parasitose, Antibiotique, Antifongique, Antiviral, Analyse coût efficacité, Economie santé, Complication, Chimioprophylaxie, Homme, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Opportunistic infection, Pneumocystis carinii, Fungi Imperfecti, Fungi, Thallophyta, Mycobacterium avium, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bacteria, Cytomegalovirus, Betaherpesvirinae, Herpesviridae, Virus, Toxoplasmosis, Protozoal disease, Parasitosis, Antibiotic, Antifungal agent, Antiviral, Cost efficiency analysis, Health economy, Complication, Chemoprophylaxis, Human, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0149767
Code Inist : 002B05C02D. Création : 21/07/1998.