PT  - JOURNAL ARTICLE
AU  - Noemia Teixeira de Siqueira-Filha
AU  - Maria de Fatima Militao de Albuquerque
AU  - Laura Cunha Rodrigues
AU  - Rosa Legood
AU  - Andreia Costa Santos
TI  - Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil
AID  - 10.1136/sextrans-2017-053277
DP  - 2018 Sep 01
TA  - Sexually Transmitted Infections
PG  - 463--469
VI  - 94
IP  - 6
4099  - http://sti.bmj.com/content/94/6/463.short
4100  - http://sti.bmj.com/content/94/6/463.full
SO  - Sex Transm Infect2018 Sep 01; 94
AB  - Objective The objective of this study was to measure the costs of people living with HIV (PLHIV) as well as active tuberculosis (TB/HIV), latent tuberculosis infection (LTBI/HIV) or without TB (HIV/AIDS).Methods We analysed the costs through the entire pathway of care during the prediagnosis and treatment periods from the Brazilian public health system perspective. We applied a combination of bottom-up and top-down approaches to capture and estimate direct medical and non-medical costs. We measured the mean cost per patient per type of care (inpatient, outpatient and emergency care) and disease category (HIV/AIDS, HIV/AIDS death, TB/HIV, TB/HIV death and LTBI/HIV).Results Between March 2014 and March 2016 we recruited 239 PLHIV. During the follow-up 26 patients were diagnosed and treated for TB and 5 received chemoprophylaxis for LTBI. During the prediagnosis and treatment period, the mean total costs for HIV or AIDS and AIDS death categories were US$1558 and US$2828, respectively. The mean total costs for TB/HIV and TB/HIV death categories were US$5289.0 and US$8281, respectively. The mean total cost for the LTBI/HIV category was US$882.Conclusions Patients with TB/HIV impose a higher economic burden on the health system than HIV/AIDS and LTBI/HIV. Patients with LTBI/HIV were the lowest cost group among all disease categories, indicating that preventive TB treatment can avoid the further costs treating active TB.Trial registration number RBR-22t943, Results.