Primary prophylaxis of disseminated histoplasmosis in HIV patients in French Guiana: arguments for cost effectiveness. - Archive ouverte HAL Access content directly
Journal Articles American Journal of Tropical Medicine and Hygiene Year : 2013

Primary prophylaxis of disseminated histoplasmosis in HIV patients in French Guiana: arguments for cost effectiveness.

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Abstract

Histoplasmosis is the first cause of acquired immunodeficiency syndrome (AIDS) and AIDS-related deaths in French Guiana. Cohort data were used to determine whether primary prophylaxis with 100 mg itraconazole for patients with CD4 counts < 150/mm(3) was cost-effective with different scenarios. For a scenario where 12% of patients died, 60% were aware of their human immunodeficiency virus (HIV) infection and adherence was only 50%, primary prophylaxis would prevent 1 death and 9 cases of histoplasmosis for a cost of 36,792 Euros per averted death, 1,533 per life-year saved, 4,415 Euros per averted case, when only counting the costs of itraconazole prophylaxis. Taking into account the total costs of hospitalization showed that primary prophylaxis would allow a savings of 185,178 Euros per year. Even in a scenario of low adherence, primary prophylaxis would be cost-effective in French Guiana, and presumably in the rest of the Guianas and the Amazon.
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Dates and versions

inserm-00913886 , version 1 (03-10-2014)

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Mathieu Nacher, Antoine Adenis, Celia Basurko, Vincent Vantilcke, Denis Blanchet, et al.. Primary prophylaxis of disseminated histoplasmosis in HIV patients in French Guiana: arguments for cost effectiveness.. American Journal of Tropical Medicine and Hygiene, 2013, 89 (6), pp.1195-8. ⟨10.4269/ajtmh.13-0082⟩. ⟨inserm-00913886⟩
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