ArticlePloS one2014
Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00433030 (Observational Cohort of HIV Infected Adults and Children in the PHPT Network Hospitals in Thailand), which is not on this map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Observational Cohort of HIV Infected Adults and Children in the PHPT Network Hospitals in Thailand
Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- Development and evaluation of a high-sensitivity RT-PCR lateral flow assay for early detection of HIV-1 infection.Heliyon · 2024Article
- Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review.Infectious diseases of poverty · 2022Article
- A focused multi-state model to estimate the pediatric and adolescent HIV epidemic in Thailand, 2005-2025.PloS one · 2022Article
- Associations of Sociodemographic and Clinical Factors with Late Presentation for Early Infant HIV Diagnosis (EID) Services in Kenya.International journal of MCH and AIDS · 2021Article
- Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana.Ghana medical journal · 2020Article
- Simulation Modeling and Metamodeling to Inform National and International HIV Policies for Children and Adolescents.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Trends and Patterns of Differences in Infectious Disease Mortality Among US Counties, 1980-2014.JAMA · 2018Article
- Clinical Impact and Cost-effectiveness of Diagnosing HIV Infection During Early Infancy in South Africa: Test Timing and Frequency.The Journal of infectious diseases · 2016Article
- Survival of HIV-1 vertically infected children.Current opinion in HIV and AIDS · 2016Article
- Early infant HIV diagnosis and entry to HIV care cascade in Thailand: an observational study.The lancet. HIV · 2016Observational
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundHIV-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.
methodsA 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%.
resultsMean 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.
conclusionIn 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.
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