IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0091004.html
   My bibliography  Save this article

Cost-Effectiveness of Early Infant HIV Diagnosis of HIV-Exposed Infants and Immediate Antiretroviral Therapy in HIV-Infected Children under 24 Months in Thailand

Author

Listed:
  • Intira Jeannie Collins
  • John Cairns
  • Nicole Ngo-Giang-Huong
  • Wasna Sirirungsi
  • Pranee Leechanachai
  • Sophie Le Coeur
  • Tanawan Samleerat
  • Nareerat Kamonpakorn
  • Jutarat Mekmullica
  • Gonzague Jourdain
  • Marc Lallemant
  • for the Programme for HIV Prevention and Treatment (PHPT) Study Team

Abstract

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.

Suggested Citation

  • Intira Jeannie Collins & John Cairns & Nicole Ngo-Giang-Huong & Wasna Sirirungsi & Pranee Leechanachai & Sophie Le Coeur & Tanawan Samleerat & Nareerat Kamonpakorn & Jutarat Mekmullica & Gonzague Jour, 2014. "Cost-Effectiveness of Early Infant HIV Diagnosis of HIV-Exposed Infants and Immediate Antiretroviral Therapy in HIV-Infected Children under 24 Months in Thailand," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0091004
    DOI: 10.1371/journal.pone.0091004
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0091004
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0091004&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0091004?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. World Bank, 2012. "World Development Indicators 2012," World Bank Publications - Books, The World Bank Group, number 6014.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    3. World Bank, 2011. "World Development Indicators 2011," World Bank Publications - Books, The World Bank Group, number 2315.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Intira Jeannie Collins & John Cairns & Nicole Ngo-Giang-Huong & Wasna Sirirungsi & Pranee Leechanachai & Sophie Le Coeur & Tanawan Samleerat & Nareerat Kamonpakorn & Jutarat Mekmullica & Gonzague Jour, 2014. "Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand," Post-Print hal-02087678, HAL.
    2. Horst Feldmann, 2013. "Technological unemployment in industrial countries," Journal of Evolutionary Economics, Springer, vol. 23(5), pages 1099-1126, November.
    3. Shankar GHIMIRE & Debasri MUKHERJEE & Eskander ALVI, 2016. "Aid-for-Trade and Export Performance of Developing Countries," Applied Econometrics and International Development, Euro-American Association of Economic Development, vol. 16(1), pages 23-34.
    4. Kari Grenade & Allan Wright, 2014. "Public Spending in Selected Caribbean Countries," Public Finance Review, , vol. 42(4), pages 487-510, July.
    5. Bill Francis & Eric Ofori, 2015. "Political regimes and stock market development," Eurasian Economic Review, Springer;Eurasia Business and Economics Society, vol. 5(1), pages 111-137, June.
    6. Rati Ram & Secil Ural, 2014. "Comparison of GDP Per Capita Data in Penn World Table and World Development Indicators," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 116(2), pages 639-646, April.
    7. Nora L. Álvarez-Berríos & Daniel J. Redo & T. Mitchell Aide & Matthew L. Clark & Ricardo Grau, 2013. "Land Change in the Greater Antilles between 2001 and 2010," Land, MDPI, vol. 2(2), pages 1-27, March.
    8. Prettner, Klaus & Bloom, David E. & Strulik, Holger, 2013. "Declining fertility and economic well-being: Do education and health ride to the rescue?," Labour Economics, Elsevier, vol. 22(C), pages 70-79.
    9. Christopher Jeffords, 2012. "Constitutional Environmental Human Rights in India: Negating a Negating Statement," Economic Rights Working Papers 21, University of Connecticut, Human Rights Institute.
    10. Kundu, Nobinkhor, 2013. "An Enquiry into the Sluggish Growth of Workers’ Remittance Determinants in Bangladesh," MPRA Paper 57718, University Library of Munich, Germany.
    11. Lisa Doyle & Ilan Noy, 2015. "The short-run nationwide macroeconomic effects of the Canterbury earthquakes," New Zealand Economic Papers, Taylor & Francis Journals, vol. 49(2), pages 134-156, August.
    12. Demir, Firat, 2013. "Growth under exchange rate volatility: Does access to foreign or domestic equity markets matter?," Journal of Development Economics, Elsevier, vol. 100(1), pages 74-88.
    13. Mohammad Reza Farzanegan, 2014. "Military Spending and Economic Growth: The Case of Iran," Defence and Peace Economics, Taylor & Francis Journals, vol. 25(3), pages 247-269, June.
    14. Juan J. Cruces & Christoph Trebesch, 2013. "Sovereign Defaults: The Price of Haircuts," American Economic Journal: Macroeconomics, American Economic Association, vol. 5(3), pages 85-117, July.
    15. von Soest, Christian & Wahman, Michael, 2013. "Are All Dictators Equal? The Selective Targeting of Democratic Sanctions against Authoritarian Regimes," GIGA Working Papers 230, GIGA German Institute of Global and Area Studies.
    16. Debasree Das Gupta, 2013. "The Effect of Gender on Women-led Small Enterprises: The Case of India," South Asian Journal of Business and Management Cases, , vol. 2(1), pages 61-75, June.
    17. Ghazi Ibrahim Al-Assaf, 2016. "Do International Remittances Affect the Performance of Labor Market in Jordan? An Impirical Investigation," Working Papers 1014, Economic Research Forum, revised Jun 2016.
    18. Colin O’Reilly, 2014. "Investment and Institutions in Post-Civil War Recovery," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 56(1), pages 1-24, March.
    19. Sophia C. Terrelonge, 2014. "For Health, Strength, and Daily Food: The Dual Impact of Remittances and Public Health Expenditure on Household Health Spending and Child Health Outcomes," Journal of Development Studies, Taylor & Francis Journals, vol. 50(10), pages 1397-1410, November.
    20. Kundu, Nobinkhor, 2015. "An Enquiry into the Sluggish Growth of Workers’ Remittance Determinants: A Case of Comilla," MPRA Paper 74800, University Library of Munich, Germany.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0091004. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.