[Economic burden and clinical course of HIV infection and AIDS today: how the variation of natural history, available treatments, and strictly related costs play a role in needs of health care].
In order to provide an updated balance of the evolution of the natural history of HIV infection, the major clinical end-points of disease morbidity and mortality were compared with the progressively increasing use of highly active antiretroviral therapy (HAART), in a cohort of patients followed by our tertiary care centre in an eight-year period including both the pre-HAART and the HAART era. Although direct expenditures for antiretroviral agents reached even 99.8% of overall costs related to drugs and blood derivatives at our entire unit in the year 2000, a clear shift towards outpatient assistance of HIV infection was realized during recent years, leading to an increased and greatly varied spectrum of infectious diseases hospitalized at our inpatient and Day-Hospital units. Due to the significant reduction of inpatient expenditures, even the elevated costs of management of HIV disease based on HAART and periodic virological and immunological monitoring are expected to remain cost-effective, at least during the next few years.
Manfredi
R
R
Sezione di Malattie Infettive, Dipartimento di Medicina Clinica Specialistica e Sperimentale, Università Alma Mater, Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna. manfredi@med.unibo.it
Calza
L
L
Gramegna
A
A
Bocchi
F
F
Fiacchi
P
P
Corsini
D
D
Chiodo
F
F
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics*; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics*; D006301:Health Services Needs and Demand; D006801:Humans
D019380:Anti-HIV Agents
Peso economico ed evoluzione dell'infezione da HIV e dell'AIDS oggi: come le modifiche della storia naturale, delle terapie disponibili e dei costi ad esse più strettamente connessi si ripercuotono sulle necessità assistenziali.