Monday, August 30, 2010

Lab tests cost effective

Carole Leach-Lemens for Aidsmap (30 August 2010)

Haiti study shows lab tests sometimes cost-effective for HIV, even in poorest countries

Only routine laboratory monitoring for asymptomatic anemia was clinically beneficial and cost-effective when compared to symptom-driven testing in a study of HIV-positive patients in Haiti.

The retrospective study of a cohort of 1800 adult patients at the Haitian Study Group for Kaposi’s sarcoma and Opportunistic Infections (GHESKIO) in Haiti on antiretroviral treatment from 2003 to 2006 is published in the advance online edition of Clinical Infectious Diseases.

Patients co-infected with tuberculosis were at increased risk for drug-induced hepatitis suggesting that targeted monitoring of co-infected patients may also be cost-effective, the authors noted.

Their results, the authors stress, show that clinical impact and cost-effectiveness vary by test and are dependent upon the antiretroviral regimen used and the prevalence of other co-morbidities such as anemia, diabetes, hepatitis and tuberculosis. As such resource-poor settings should choose accordingly, they note.

Reference

Clinical impact and cost of monitoring for asymptomatic laboratory abnormalities among patients receiving antiretroviral therapy in a resource-poor setting.
Serena P. Koenig, Bruce R. Schackman, Cynthia Riviere, Paul Leger, Macarthur Charles, Patrice Severe, Charlene Lastimoso, Nicole Colucci, Jean W. Pape, and Daniel W. Fitzgerald.
Clinical Infectious Diseases. Volume 51, Issue 5, Page 600–608, Sep 2010 DOI: 10.1086/655762

Link to CID abstract

Link to Aidsmap article

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