Central Clinical School, Monash University.
Melbourne Sexual Health Centre, The Alfred.
AIDS. 2021 Jul 1;35(8):1273-1281. doi: 10.1097/QAD.0000000000002887.
There are an estimated 38 million people with HIV (PWH), with significant economic consequences. We aimed to collate global lifetime costs for managing HIV.
We conducted a systematic review (PROSPERO: CRD42020184490) using five databases from 1999 to 2019.
Studies were included if they reported primary data on lifetime costs for PWH. Two reviewers independently assessed the titles and abstracts, and data were extracted from full texts: lifetime cost, year of currency, country of currency, discount rate, time horizon, perspective, method used to estimate cost and cost items included. Descriptive statistics were used to summarize the discounted lifetime costs [2019 United States dollars (USD)].
Of the 505 studies found, 260 full texts were examined and 75 included. Fifty (67%) studies were from high-income, 22 (29%) from middle-income and three (4%) from low-income countries. Of the 65 studies, which reported study perspective, 45 (69%) were healthcare provider and the remainder were societal. The median lifetime costs for managing HIV differed according to: country income level: $5221 [interquartile range (IQR)]: 2978-11 177) for low-income to $377 820 (IQR: 260 176-541 430) for high-income; study perspective: $189 230 (IQR: 14 794-424 069) for healthcare provider, to $508 804 (IQR: 174 781-812 418) for societal; and decision model: $190 255 (IQR: 13 588-429 772) for Markov cohort, to $283 905 (IQR: 10 558-453 779) for microsimulation models.
Estimating the lifetime costs of managing HIV is useful for budgetary planning and to ensure HIV management is affordable for all. Furthermore, HIV prevention strategies need to be strengthened to avert these high costs of managing HIV.
全球约有 3800 万艾滋病毒感染者（PWH），这给经济带来了巨大的影响。本研究旨在汇总全球管理 HIV 的终生成本。
我们进行了一项系统评价（PROSPERO：CRD42020184490），使用了五个数据库，检索时间从 1999 年到 2019 年。
我们纳入了报告 PWH 终生成本的原始数据的研究。两名评审员独立评估标题和摘要，从全文中提取数据：终生成本、货币年份、货币国家、贴现率、时间范围、视角、用于估计成本的方法以及包含的成本项目。使用描述性统计方法总结了贴现后的终生成本（2019 年美元）。
在 505 项研究中，有 260 篇全文进行了评估，其中 75 篇被纳入。50 项（67%）研究来自高收入国家，22 项（29%）来自中等收入国家，3 项（4%）来自低收入国家。在报告研究视角的 65 项研究中，45 项（69%）来自医疗保健提供者，其余来自社会。根据国家收入水平，管理 HIV 的终生成本存在差异：低收入国家为 5221 美元（IQR：2978-11177），高收入国家为 377820 美元（IQR：260176-541430）；研究视角，医疗保健提供者为 189230 美元（IQR：14794-424069），社会为 508804 美元（IQR：174781-812418）；决策模型，马尔可夫队列为 190255 美元（IQR：13588-429772），微模拟模型为 283905 美元（IQR：10558-453779）。
估算管理 HIV 的终生成本有助于预算规划，并确保所有患者都能负担得起 HIV 管理费用。此外，需要加强 HIV 预防策略，以避免这些管理 HIV 的高昂成本。
