Journal Article

Prevention of Human Immunodeficiency Virus—Related Opportunistic Infections in France: A Cost-Effectiveness Analysis

Y. Yazdanpanah, S. J. Goldie, A. D. Paltiel, E. Losina, L. Coudeville, M. C. Weinstein, Y. Gerard, A. D. Kimmel, H. Zhang, R. Salamon, Y. Mouton and K. A. Freedberg

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 1, pages 86-96
Published in print January 2003 | ISSN: 1058-4838
Published online January 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/344902
Prevention of Human Immunodeficiency Virus—Related Opportunistic Infections in France: A Cost-Effectiveness Analysis

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

A simulation model of human immunodeficiency virus (HIV) disease, which incorporated French data on the progression of HIV disease in the absence of antiretroviral therapy and on cost, was used to determine the clinical impact and cost-effectiveness of different strategies for the prevention of opportunistic infections in French patients who receive highly active antiretroviral therapy (HAART). Compared with use of no prophylaxis, use of trimethoprim-sulfamethoxazole (TMP-SMZ) increased per-person lifetime costs from €185,600 to €187,900 and quality-adjusted life expectancy from 112.2 to 113.7 months, for an incremental cost-effectiveness ratio of €18,700 per quality-adjusted life-year (€/QALY) gained. Compared with use of TMP-SMZ alone, use of TMP-SMZ plus azithromycin cost €23,900/QALY gained; adding fluconazole cost an additional €54,500/QALY gained. All strategies that included oral ganciclovir had cost-effectiveness ratios that exceeded €100,000/QALY gained. In the era of HAART, on the basis of French data, prophylaxis against Pneumocystis carinii pneumonia, toxoplasmic encephalitis, and Mycobacterium avium complex bacteremia is cost-effective. Prophylaxis against fungal and cytomegalovirus infections is less cost-effective than are other therapeutic options for HIV disease and should remain of lower priority.

Journal Article.  5384 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.