In this section
@article{Wong:2019:10.1001/jamanetworkopen.2019.10960,
author = {Wong, NS and Chan, KCW and Wong, BCK and Leung, CC and Chan, WK and Lin, AWC and Lui, GCY and Mitchell, KM and Lee, SS},
doi = {10.1001/jamanetworkopen.2019.10960},
journal = {JAMA Network Open},
pages = {1--12},
title = {Latent tuberculosis infection testing strategies for HIV-positive individuals in Hong Kong.},
url = {http://dx.doi.org/10.1001/jamanetworkopen.2019.10960},
volume = {2},
year = {2019}
}
TY - JOUR
AB - Importance: With immune recovery following early initiation of antiretroviral therapy (ART), the risk of tuberculosis (TB) reactivation among individuals with HIV could be reduced. The current strategy of annual latent TB infection (LTBI) testing should be revisited to increase cost-effectiveness and reduce the intensity of testing for individuals. Objective: To analyze the cost-effectiveness of LTBI testing strategies for individuals in Hong Kong with HIV who had negative LTBI test results at baseline. Design, Setting, and Participants: This decision analytical model study using a cost-effectiveness analysis included 3130 individuals with HIV in Hong Kong, China, which has an intermediate TB burden and a low incidence of HIV-TB coinfection. A system dynamics model of individuals with HIV attending a major HIV specialist clinic in Hong Kong was developed and parameterized by longitudinal clinical and LTBI testing records of patients during a 15-year period. The study population was stratified by age group, CD4 lymphocyte level, ART status, and right of abode. Alternative strategies for LTBI testing after a baseline test were compared with annual testing under different coverages of ART, LTBI testing, and LTBI treatment scenarios in the model. An annual discounting rate of 3.5% was used in cost-effectiveness analysis. Main Outcomes and Measures: Proportion of new TB cases averted above base case scenario, discounted quality-adjusted life-years gained (QALYG), incremental cost, and incremental cost-effectiveness ratios in 2017 to 2023. Results: A total of 3130 patients with HIV (2740 [87.5%] male and 2800 [89.5%] younger than 50 years at HIV diagnosis) with 16630 person-years of follow-up data from 2002 to 2017 were analyzed. Of these, 94 patients (0.67 [95% CI, 0.51-0.91] per 100 person-years) developed TB. Model estimates of cumulative number of TB cases would reach 146 by 2023, with the annual number of new TB diagnoses ranging from 6 to 8. For patients who had ne
AU - Wong,NS
AU - Chan,KCW
AU - Wong,BCK
AU - Leung,CC
AU - Chan,WK
AU - Lin,AWC
AU - Lui,GCY
AU - Mitchell,KM
AU - Lee,SS
DO - 10.1001/jamanetworkopen.2019.10960
EP - 12
PY - 2019///
SN - 2574-3805
SP - 1
TI - Latent tuberculosis infection testing strategies for HIV-positive individuals in Hong Kong.
T2 - JAMA Network Open
UR - http://dx.doi.org/10.1001/jamanetworkopen.2019.10960
UR - https://www.ncbi.nlm.nih.gov/pubmed/31490541
UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2749452
VL - 2
ER -
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