Cost-effectiveness of a Novel Lipoarabinomannan Test for Tuberculosis in Patients With Human Immunodeficiency Virus

A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and higher cost than the first-generation AlereLAM assay. We evaluated the cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective of symptoms. We use...

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Bibliographic Details
Published in:Clinical infectious diseases 2021-10, Vol.73 (7), p.e2077-e2085
Main Authors: Reddy, Krishna P, Denkinger, Claudia M, Broger, Tobias, McCann, Nicole C, Gupta-Wright, Ankur, Kerkhoff, Andrew D, Pei, Pamela P, Shebl, Fatma M, Fielding, Katherine L, Nicol, Mark P, Horsburgh, C Robert, Meintjes, Graeme, Freedberg, Kenneth A, Wood, Robin, Walensky, Rochelle P
Format: Article
Language:English
Subjects:
Cost-Benefit Analysis
HIV
HIV Infections - complications
Humans
Lipopolysaccharides
Online Only
Retrospective Studies
Sensitivity and Specificity
Sputum
Tuberculosis - diagnosis
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Summary:A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and higher cost than the first-generation AlereLAM assay. We evaluated the cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective of symptoms. We used a microsimulation model to project clinical and economic outcomes of 3 testing strategies: (1) sputum Xpert MTB/RIF (Xpert), (2) sputum Xpert plus urine AlereLAM (Xpert+AlereLAM), (3) sputum Xpert plus urine FujiLAM (Xpert+FujiLAM). The modeled cohort matched that of a 2-country clinical trial. We applied diagnostic yields from a retrospective study (yields for Xpert/Xpert+AlereLAM/Xpert+FujiLAM among those with CD4
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciaa1698