title: Cost estimation of first-line antiretroviral therapy with zidovudine/stavudine as the nucleoside backbone in India: a pilot study.
abstract: BACKGROUND
  In India, a zidovudine-based regimen is preferred as the first-line drug treatment for HIV, despite high rates of drug toxicity. This study estimates the treatment costs for HIV.
  
  
  METHODS
  Eligible patients were enrolled from Antiretroviral Therapy Center, Christian Medical College, India. Baseline demographic and clinical characteristics, medical and nonmedical expenditure, and lost income were collected.
  
  
  RESULTS
  Of 41 patients enrolled and followed for 6 months, HIV treatment toxicity and opportunistic infections were reported by 12 (29%) and 13 (31.7%) patients, respectively. The median total costs, direct costs, and out-of-pocket expenditure were Indian rupees (INR) 9418 (US$181), 8727 (US$168), and 7157 (US$138), respectively. Diagnostic tests accounted for 58% of the expenses. HIV treatment accounted for 34% of the median income earned INR 21 000 (US$404). Expenditure for treatment with toxicity was 44% higher than without toxicity.
  
  
  CONCLUSIONS
  Current treatment is associated with toxicity, increasing treatment costs and imposing a significant economic burden.
authors.affiliation: Department of Community Medicine and Public Health, Nutrition/Infection Unit, Tufts University, Boston, MA, USA Department of Medicine, Unit I & ID, Christian Medical College, Vellore, Tamil Nadu, India sowmyanarayanan.thuppal@tufts.edu.
authors.forename: Sowmyanarayanan V
authors.initials: SV
authors.lastname: Thuppal
authors.affiliation: Department of Medicine, Unit I & ID, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Karthik
authors.affiliation: Department of Medicine, Unit I & ID, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Ooriapadical C
authors.initials: OC
authors.lastname: Abraham
authors.affiliation: Department of Community Medicine and Public Health, Nutrition/Infection Unit, Tufts University, Boston, MA, USA.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Wanke
authors.affiliation: Department of Community Medicine and Public Health, Nutrition/Infection Unit, Tufts University, Boston, MA, USA Voi Research Centre, Voi, Kenya.
authors.forename: Mkaya
authors.initials: M
authors.lastname: Mwamburi
authors.affiliation: Sackler School of Biomedical Sciences, Tufts University, Boston, MA, USA Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Terrin
authors.affiliation: Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Cohen
authors.affiliation: Department of Medicine, Unit I & ID, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Mathai
authors.affiliation: Department of GI Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Muliyil
authors.affiliation: Department of GI Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics*; D005102:Health Expenditures; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D018119:Stavudine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D055815:Young Adult; D015215:Zidovudine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine; D018119:Stavudine
keywords: ART; HIV; India; cost of treatment; drug toxicity; economic burden