Cost‐efectiveness of newer technologies for the diagnosis of Mycobacterium tuberculosis infection in Brazilian people living with HIV
Cost‐efectiveness of newer technologies for the diagnosis of Mycobacterium tuberculosis infection in Brazilian people living with HIV
Data
2020
Autores
Stefen, Ricardo E.
Pinto, Márcia
Kritski, Afranio
Trajman, Anete
Journal Title
Journal ISSN
Volume Title
Publisher
Scientifc Reports
Resumo
Tuberculosis is the leading cause of death among people living with HIV (PLH). Preventive tuberculosis
therapy reduces mortality in PLH, especially in those with a positive tuberculin skin test (TST). New,
more specifc technologies for detecting latent tuberculosis infection (LTBI) are now commercially
available. We sought to analyse the cost-efectiveness of four diferent strategies for the diagnosis of
LTBI in PLH in Brazil, from the Brazilian public health care system perspective. We developed a Markov
state-transition model comparing four strategies for the diagnosis of LTBI over 20 years. The strategies
consisted of TST with the currently used protein purifed derivative (PPD RT 23), two novel skin tests
using recombinant allergens (Diaskintest [Generium Pharmaceutical, Moscow, Russia] and EC [Zhifei
Longcom Biologic Pharmacy Co., Anhui, China]), and the QuantiFERON-TB-Gold-Plus (Qiagen, Hilden,
Germany). The main outcome was cost (in 2020 US dollars) per quality-adjusted life years (QALY). For
the base case scenario, the Diaskintest was dominant over all other examined strategies. The cost
saving estimate per QALY was US $1375. In sensitivity analyses, the Diaskintest and other newer tests
remained cost-saving compared to TST. For PLH, TST could be replaced by more specifc tests in Brazil,
considering the current national recommendations.
Description
Palavras-chave
Adolescent, Adult, Brazil / epidemiology, Costs and Cost Analysis, Female, HIV Infections* / diagnosis, HIV Infections* / drug therapy, HIV Infections* / economics, HIV Infections* / epidemiology, HIV-1*, Humans, Latent Tuberculosis* / diagnosis, Latent Tuberculosis* / drug therapy, Latent Tuberculosis* / economics, Latent Tuberculosis* / epidemiology, Male, Middle Aged, Mycobacterium tuberculosis*
Citação
Steffen RE, Pinto M, Kritski A, Trajman A. Cost-effectiveness of newer technologies for the diagnosis of Mycobacterium tuberculosis infection in Brazilian people living with HIV. Sci Rep. 2020 Dec 11;10(1):21823. doi: 10.1038/s41598-020-78737-w.