NPMS-HHC Coordinating and Analytic Centre, London, United Kingdom.
PLoS One. 2010 Dec 30;5(12):e15677. doi: 10.1371/journal.pone.0015677.
The number of people living with HIV (PLHIV) is increasing in the UK. This study estimated the annual population cost of providing HIV services in the UK, 1997-2006 and projected them 2007-2013.
Annual cost of HIV treatment for PLHIV by stage of HIV infection and type of ART was calculated (UK pounds, 2006 prices). Population costs were derived by multiplying the number of PLHIV by their annual cost for 1997-2006 and projected 2007-2013.
Average annual treatment costs across all stages of HIV infection ranged from £17,034 in 1997 to £18,087 in 2006 for PLHIV on mono-therapy and from £27,649 in 1997 to £32,322 in 2006 for those on quadruple-or-more ART. The number of PLHIV using NHS services rose from 16,075 to 52,083 in 2006 and was projected to increase to 78,370 by 2013. Annual population cost rose from £104 million in 1997 to £483 million in 2006, with a projected annual cost between £721 and £758 million by 2013. When including community care costs, costs increased from £164 million in 1997, to £683 million in 2006 and between £1,019 and £1,065 million in 2013.
Increased number of PLHIV using NHS services resulted in rising UK population costs. Population costs are expected to continue to increase, partly due to PLHIV's longer survival on ART and the relative lack of success of HIV preventing programs. Where possible, the cost of HIV treatment and care needs to be reduced without reducing the quality of services, and prevention programs need to become more effective. While high income countries are struggling to meet these increasing costs, middle- and lower-income countries with larger epidemics are likely to find it even more difficult to meet these increasing demands, given that they have fewer resources.
在英国，感染艾滋病毒的人数（PLHIV）正在增加。本研究估算了 1997-2006 年英国提供艾滋病毒服务的年度人口成本，并对 2007-2013 年的成本进行了预测。
根据艾滋病毒感染阶段和抗逆转录病毒治疗（ART）类型，计算 PLHIV 的艾滋病毒治疗年度费用（1997-2006 年为英镑，2006 年价格）。人口成本是通过将 PLHIV 的数量乘以其在 1997-2006 年的年度成本和 2007-2013 年的预测成本得出的。
在所有艾滋病毒感染阶段，使用单一疗法的 PLHIV 的平均年度治疗费用从 1997 年的 17034 英镑降至 2006 年的 18087 英镑，而使用四联或更多 ART 的 PLHIV 的费用从 1997 年的 27649 英镑降至 2006 年的 32322 英镑。使用国民保健服务的 PLHIV 人数从 1997 年的 16075 人增加到 2006 年的 52083 人，并预计到 2013 年将增加到 78370 人。1997 年的年度人口成本为 1.04 亿英镑，到 2006 年增至 4.83 亿英镑，预计到 2013 年每年将在 7.21 亿至 7.58 亿英镑之间。当包括社区护理费用时，成本从 1997 年的 1.64 亿英镑增加到 2006 年的 6.83 亿英镑，预计到 2013 年将在 10.19 亿至 10.65 亿英镑之间。
使用国民保健服务的 PLHIV 人数增加导致英国人口成本上升。预计人口成本将继续增加，部分原因是 PLHIV 在接受 ART 治疗后存活时间延长，以及艾滋病毒预防计划相对缺乏成功。在可能的情况下，需要在不降低服务质量的情况下降低艾滋病毒治疗和护理成本，并使预防计划更加有效。当高收入国家正在努力应对这些不断增加的成本时，中低收入国家由于资源较少，可能更难以满足这些不断增长的需求，而这些国家的艾滋病毒流行规模更大。
