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• W2769331331 startingPage "e1002446" @default.
• W2769331331 abstract "Background The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa. Method and findings Using the Cost-effectiveness of Preventing AIDS Complications (CEPAC)–Pediatric model, we simulated EID testing at age 6 weeks for HIV-exposed infants without and with confirmatory testing. We assumed a NAAT cost of US$25, NAAT specificity of 99.6%, NAAT sensitivity of 100% for infants infected in pregnancy or at least 4 weeks prior to testing, and a mother-to-child transmission (MTCT) rate at 12 months of 4.9%; we simulated guideline-concordant rates of testing uptake, result return, and antiretroviral therapy (ART) initiation (100%). After diagnosis, infants were linked to and retained in care for 10 years (false-positive) or lifelong (true-positive). All parameters were varied widely in sensitivity analyses. Outcomes included number of infants with false-positive diagnoses linked to ART per 1,000 ART initiations, life expectancy (LE, in years) and per-person lifetime HIV-related healthcare costs. Both without and with confirmatory testing, LE was 26.2 years for HIV-infected infants and 61.4 years for all HIV-exposed infants; clinical outcomes for truly infected infants did not differ by strategy. Without confirmatory testing, 128/1,000 ART initiations were false-positive diagnoses; with confirmatory testing, 1/1,000 ART initiations were false-positive diagnoses. Because confirmatory testing averted costly HIV care and ART in truly HIV-uninfected infants, it was cost-saving: total cost US$1,790/infant tested, compared to US$1,830/infant tested without confirmatory testing. Confirmatory testing remained cost-saving unless NAAT cost exceeded US$400 or the HIV-uninfected status of infants incorrectly identified as infected was ascertained and ART stopped within 3 months of starting. Limitations include uncertainty in the data used in the model, which we examined with sensitivity and uncertainty analyses. We also excluded clinical harms to HIV-uninfected infants incorrectly treated with ART after false-positive diagnosis (e.g., medication toxicities); including these outcomes would further increase the value of confirmatory testing. Conclusions Without confirmatory testing, in settings with MTCT rates similar to that of South Africa, more than 10% of infants who initiate ART may reflect false-positive diagnoses. Confirmatory testing prevents inappropriate HIV diagnosis, is cost-saving, and should be adopted in all EID programmes." @default.
• W2769331331 created "2017-12-04" @default.
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• W2769331331 date "2017-11-21" @default.
• W2769331331 modified "2023-10-16" @default.
• W2769331331 title "The value of confirmatory testing in early infant HIV diagnosis programmes in South Africa: A cost-effectiveness analysis" @default.
• W2769331331 cites W1539475119 @default.
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• W2769331331 cites W1662456024 @default.
• W2769331331 cites W1765275521 @default.
• W2769331331 cites W1969671892 @default.
• W2769331331 cites W1971023097 @default.
• W2769331331 cites W1974075607 @default.
• W2769331331 cites W1977328150 @default.
• W2769331331 cites W1989690695 @default.
• W2769331331 cites W1996798730 @default.
• W2769331331 cites W1998715001 @default.
• W2769331331 cites W2001513054 @default.
• W2769331331 cites W2002432974 @default.
• W2769331331 cites W2002726825 @default.
• W2769331331 cites W2006979416 @default.
• W2769331331 cites W2024165077 @default.
• W2769331331 cites W2025486350 @default.
• W2769331331 cites W2025656757 @default.
• W2769331331 cites W2035446688 @default.
• W2769331331 cites W2040830489 @default.
• W2769331331 cites W2044228371 @default.
• W2769331331 cites W2044565618 @default.
• W2769331331 cites W2056819207 @default.
• W2769331331 cites W2065464437 @default.
• W2769331331 cites W2066340404 @default.
• W2769331331 cites W2072612814 @default.
• W2769331331 cites W2098811591 @default.
• W2769331331 cites W2101465292 @default.
• W2769331331 cites W2116914456 @default.
• W2769331331 cites W2117457890 @default.
• W2769331331 cites W2122986037 @default.
• W2769331331 cites W2126184004 @default.
• W2769331331 cites W2131553265 @default.
• W2769331331 cites W2132730520 @default.
• W2769331331 cites W2134746895 @default.
• W2769331331 cites W2136376685 @default.
• W2769331331 cites W2139088138 @default.
• W2769331331 cites W2143025931 @default.
• W2769331331 cites W2144396940 @default.
• W2769331331 cites W2144925599 @default.
• W2769331331 cites W2146682154 @default.
• W2769331331 cites W2148521133 @default.
• W2769331331 cites W2154053721 @default.
• W2769331331 cites W2156935773 @default.
• W2769331331 cites W2161202915 @default.
• W2769331331 cites W2161522587 @default.
• W2769331331 cites W2164723930 @default.
• W2769331331 cites W2165826479 @default.
• W2769331331 cites W2167835546 @default.
• W2769331331 cites W2169652604 @default.
• W2769331331 cites W2252572957 @default.
• W2769331331 cites W2262700604 @default.
• W2769331331 cites W2303927938 @default.
• W2769331331 cites W2333566082 @default.
• W2769331331 cites W2515870255 @default.
• W2769331331 cites W2538706177 @default.
• W2769331331 cites W2593373383 @default.
• W2769331331 cites W2606320882 @default.
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• W2769331331 doi "https://doi.org/10.1371/journal.pmed.1002446" @default.
• W2769331331 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/5697827" @default.
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