Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries.
Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries.
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DOI：
10.1093/infdis/jiv040
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发表时间：
2015-08-15
期刊：
影响因子：
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通讯作者：
Phillips A
中科院分区：
文献类型：
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作者：
Cambiano V;Ford D;Mabugu T;Napierala Mavedzenge S;Miners A;Mugurungi O;Nakagawa F;Revill P;Phillips A
研究表明，与提供者提供的艾滋病毒检测和咨询（PHTC）相比，自我检测人类免疫缺陷病毒（HIV）在个人中是高度可接受的，并且可以节省成本，尽管长期人口水平的影响尚不确定。我们评估了2015年在津巴布韦这样的国家引入自我检测的成本效益，以及20年的时间框架。使用HIV合成模型。考虑了两种情况。在参考情景中，无法进行自我检测，并且假设从2015年起，首次和重复PHTC的比率将增加，与过去的趋势一致。在干预方案中，自我测试的单位成本为3美元。我们预测，自我检测的引入将导致7500万美元的医疗保健成本的适度节省，同时在20年内避免约7000个残疾调整生命年。调查结果是强大的大多数假设的变化，但是，自我检测的成本较高，较低的联系，以照顾的人的诊断是一个积极的自我检测结果的结果，以及抗逆转录病毒治疗的资格标准的门槛较低，可能会导致自我检测的情况下，是不符合成本效益。这一分析表明，引入自我检测提供了一些健康益处，并可能很好地节省成本。
Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. This analysis suggests that introducing self-testing offers some health benefits and may well save costs.