When the researchers considered a screening program in which the prevalence of unidentified HIV infection was one percent, the model found an increase in life expectancy of about 1.5 years for patients infected with HIV, costing $41,736 per quality-adjusted life-year gained compared to current practice. When the costs and benefits to the partner were included in the model, the cost-effectiveness of screening became even more favorable with an incremental cost effectiveness of $15,078 per quality-adjusted life-year.
"Additionally, the model showed that the prevalence of HIV can be as low as 0.5 percent and still remain below the $50,000 per quality-adjusted life-year threshold," Sanders continued. "When you then include the costs and benefits to partners, the prevalence can go as low as 0.05 percent before reaching the $50,000 threshold.
"These findings suggest that routine screening is likely to be cost-effective at a substantially lower prevalence than previously recognized," Sanders said. "We believe that in many different health care settings, routine HIV screening can provide important health benefits for a reasonable investment in health care resources."
Expanding the scope of routine HIV screening is important, the researchers said, because patients can be infected, as well as infectious, for many years before they start showing symptoms of the disease.
"Recent data from the CDC has shown that for 41 percent of HIV-infected patients in the U.S., symptoms of AIDS develop within a year of diagnosis, suggesting that opportunities to reduce risk behaviors or initiate early treatment had been missed," Sanders said.
Sander also cited a rec
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
9-Feb-2005