[Cost-effectiveness of hepatitis C treatment in slow virologic responders coinfected with HIV].
Recent evidence has demonstrated that slow responders may benefit from antiviral treatment in HCV/HIV coinfection. This study aimed to evaluate the cost-effectiveness of HCV treatment in individuals with genotype 1 coinfected with HIV, with peg-interferon in combination with ribavirin, compared to the inclusion (versus non-inclusion) of slow responders. A Markov model was developed that simulated the progression of liver disease in a hypothetical cohort of one thousand men over 40 years of age, considering the Brazilian Unified National Health System (SUS) perspective and a 30-year timeline. The extension of treatment to slow responders provided a 60% increase in the number of individuals who eliminated HCV and an incremental cost-effectiveness ratio of 44,171 BRL/QALY, below the acceptability threshold proposed by World Health Organization. Sensitivity analysis did not alter the results. The inclusion of HCV/ HIV-coinfected slow virologic responders in the treatment protocol is shown to be a cost-effective strategy for the SUS.
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil. mps_rodrigues@yahoo.com.br
Marcus Paulo da Silva
MP
Rodrigues
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Cid Manso de Mello
CM
Vianna
Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Niterói, Brasil.
Gabriela Bittencourt Gonzalez
GB
Mosegui
Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Frances Valéria
FV
Costa e Silva
Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Antonio Augusto de Freitas
AA
Peregrino
Instituto Nacional de Câncer, Rio de Janeiro, Brasil.
Fernando Nagib
FN
Jardim
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000191:economics; D060085:Coinfection; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination / Q000191:economics; D015658:HIV Infections; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000191:economics; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000191:economics; D012254:Ribavirin / Q000008:administration & dosage* / Q000191:economics
D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a