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HIV Screening via Fourth-Generation Immunoassay or Nucleic Acid Amplification Test in the United States: A Cost-Effectiveness Analysis

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  • Elisa F Long

Abstract

Background: At least 10% of the 56,000 annual new HIV infections in the United States are caused by individuals with acute HIV infection (AHI). It unknown whether the health benefits and costs of routine nucleic acid amplification testing (NAAT) are justified, given the availability of newer fourth-generation immunoassay tests. Methods: Using a dynamic HIV transmission model instantiated with U.S. epidemiologic, demographic, and behavioral data, I estimated the number of acute infections identified, HIV infections prevented, quality-adjusted life years (QALYs) gained, and the cost-effectiveness of alternative screening strategies. I varied the target population (everyone aged 15-64, injection drug users [IDUs] and men who have sex with men [MSM], or MSM only), screening frequency (annually, or every six months), and test(s) utilized (fourth-generation immunoassay only, or immunoassay followed by pooled NAAT). Results: Annual immunoassay testing of MSM reduces incidence by 9.5% and costs

Suggested Citation

  • Elisa F Long, 2011. "HIV Screening via Fourth-Generation Immunoassay or Nucleic Acid Amplification Test in the United States: A Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-10, November.
    • Handle: RePEc:plo:pone00:0027625
    DOI: 10.1371/journal.pone.0027625
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    References listed on IDEAS

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    1. Angela B Hutchinson & Pragna Patel & Stephanie L Sansom & Paul G Farnham & Timothy J Sullivan & Berry Bennett & Peter R Kerndt & Robert K Bolan & James D Heffelfinger & Vimalanand S Prabhu & Bernard M, 2010. "Cost-Effectiveness of Pooled Nucleic Acid Amplification Testing for Acute HIV Infection after Third-Generation HIV Antibody Screening and Rapid Testing in the United States: A Comparison of Three Publ," PLOS Medicine, Public Library of Science, vol. 7(9), pages 1-10, September.
    2. Lum, P.J. & Ochoa, K.C. & Hahn, J.A. & Shafer, K.P. & Evans, J.L. & Moss, A.R., 2003. "Hepatitis B Virus Immunization among Young Injection Drug Users in San Francisco, Calif: The UFO Study," American Journal of Public Health, American Public Health Association, vol. 93(6), pages 919-923.
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    Cited by:

    1. Hrayer Aprahamian & Hadi El-Amine, 2022. "Optimal Screening of Populations with Heterogeneous Risk Profiles Under the Availability of Multiple Tests," INFORMS Journal on Computing, INFORMS, vol. 34(1), pages 150-164, January.
    2. Hani Serag & Isabel Clark & Cherith Naig & David Lakey & Yordanos M. Tiruneh, 2022. "Financing Benefits and Barriers to Routine HIV Screening in Clinical Settings in the United States: A Scoping Review," IJERPH, MDPI, vol. 20(1), pages 1-13, December.
    3. Lauren E Cipriano & Gregory S Zaric & Mark Holodniy & Eran Bendavid & Douglas K Owens & Margaret L Brandeau, 2012. "Cost Effectiveness of Screening Strategies for Early Identification of HIV and HCV Infection in Injection Drug Users," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-14, September.
    4. Bert, Fabrizio & Gualano, Maria Rosaria & Biancone, Paolo & Brescia, Valerio & Camussi, Elisa & Martorana, Maria & Secinaro, Silvana & Siliquini, Roberta, 2018. "Cost-effectiveness of HIV screening in high-income countries: A systematic review," Health Policy, Elsevier, vol. 122(5), pages 533-547.

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