Document 0022
 DOCN  M95A0022
 TI    Isoniazid prophylactic therapy for tuberculosis in HIV-seropositive
       patients--a least-cost analysis.
 DT    9510
 AU    Masobe P; Lee T; Price M; Department of Community Health, University of
       the Witwatersrand,; Johannesburg.
 SO    S Afr Med J. 1995 Feb;85(2):75-81. Unique Identifier : AIDSLINE
       MED/95320698
 AB    The expected upsurge in the number of new cases of tuberculosis
       resulting from the HIV/AIDS epidemic prompted an examination of the
       feasibility of prevention strategies to limit the increase in clinical
       tuberculosis. A computer spreadsheet model was developed to estimate the
       costs and benefits that would result from isoniazid chemoprophylaxis for
       tuberculosis in a hypothetical cohort of 100,000 HIV-seropositive people
       in South Africa over a period of 8 years. At a 50% prevalence of
       tuberculosis infection among those at high background risk, and 5-10%
       among those at low risk, there would have been 34,000 cases of active
       tuberculosis in the cohort and their contacts if no prophylactic therapy
       had been used. On the other hand, a chemoprophylaxis policy would have
       meant only 12,200 cases of tuberculosis, if a patient compliance rate of
       68.5% had been assumed. Such a policy would have prevented 21,800 cases
       of active tuberculosis. The estimated total discounted cost of a
       chemoprophylaxis programme would have been R51.3 million. In the absence
       of preventive therapy the discounted cost of treating patients with
       active tuberculosis would have been R91.9 million over the 8-year
       period. Therefore, if the benefits of chemoprophylaxis were defined in
       terms of averted health care costs, such a policy would have resulted in
       net savings of R40.6 million. This study did not estimate losses in
       production associated with tuberculosis treatment or the value of
       preventing tuberculosis per se, though such indirect costs would have
       increased the benefit of the prevention programme.(ABSTRACT TRUNCATED AT
       250 WORDS)
 DE    Ambulatory Care/*ECONOMICS  Computer Simulation  Cost of Illness  Costs
       and Cost Analysis  Feasibility Studies  Hospitalization/*ECONOMICS
       Human  HIV Seropositivity/*COMPLICATIONS
       Isoniazid/ECONOMICS/*THERAPEUTIC USE  Patient Compliance  South Africa
       Tuberculosis/ECONOMICS/*PREVENTION & CONTROL  JOURNAL ARTICLE

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