6th IAS Conference On HIV Pathogenesis, Treatment and Prevention

Diagnostics: Innovation, Cost-Effectiveness and Scale-Up MOAD01
Type:
Oral Abstract Session Back
Venue: SR 3
Time: 16:30 - 18:00, 18.07.2011
Code: MOAD01
Chairs: Christine Rouzioux, France
Guido Antonelli, Italy



Presentations in this session:

16:30
MOAD0101
Abstract
Powerpoint
Slides with audio		Cost comparison of point-of-care and laboratory CD4 testing in resource-limited settings
Presented by Ilesh V. Jani, Mozambique
I. Jani1, N. Sitoe1, J. Quevedo2, J. Lehe2, T. Peter2
1Instituto Nacional da Saude, Hospital Central de Maputo, Maputo, Mozambique, 2Clinton Health Access Initiative, Maputo, Mozambique

16:40
MOAD0102
Abstract
Powerpoint
Slides with audio		Cost-effectiveness of Xpert MTB/RIF for screening for tuberculosis prior to antiretroviral therapy in South Africa
Presented by Jason R Andrews, United States
J.R. Andrews1, S.D. Lawn2,3, C. Rusu1, R. Wood2, E. Rhode1, M.A. Bender4, C.R. Horsburgh5, F. Noubary1, K.A. Freedberg1, R.P. Walensky1
1Massachusets General Hospital, Division of Infectious Diseases, Boston, United States, 2University of Cape Town, Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa, 3London School of Hygiene and Tropical Medicine, Clinical Research Unit, Department of Infectious and Tropical Diseases, London, United Kingdom, 4New York University School of Medicine, Division of Infectious Diseases, New York, United States, 5Boston University School of Public Health, Department of Epidemiology, Boston, United States

16:50
MOAD0103
Abstract
Powerpoint
Slides with audio		Rapid point-of-care CD4 testing at mobile HIV testing sites to increase linkage to care: an evaluation of a pilot program in South Africa
Presented by Bruce Larson, United States
B. Larson1, K. Bistline2, B. Ndibongo2, T. Xulu3, A. Brennan1, L. Long2, S. Rosen1, M. Fox1
1Boston University School of Public Health, Boston, United States, 2Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa, 3Right to Care, Johannesburg, South Africa

17:00
MOAD0104
Abstract
Powerpoint
Slides with audio		The cost-effectiveness of on-site rapid HIV testing in substance abuse treatment: results of the CTN 0032 randomized trial
Presented by Bruce R. Schackman, United States
B.R. Schackman1, L.R. Metsch2, G.N. Colfax3, J.A. Leff1, A.Y. Wong4, C.A. Scott4, D.J. Feaster2, L. Gooden2, T. Matheson3, R.N. Mandler5, L.F. Haynes6, A.D. Paltiel7, R.P. Walensky4,8,9
1Weill Cornell Medical College, Department of Public Health, New York, United States, 2University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, Miami, United States, 3San Francisco Department of Public Health, HIV Prevention and Research Section, San Francisco, United States, 4Massachusetts General Hospital, Division of General Medicine, Boston, United States, 5National Institute on Drug Abuse, Center for Clinical Trials Network, Bethesda, United States, 6Medical University of South Carolina, Division of Clinical Neuroscience, Charleston, United States, 7Yale School of Public Health, Division of Health Policy and Administration, New Haven, United States, 8Brigham and Women's Hospital, Division of Infectious Diseases, Boston, United States, 9Massachusets General Hospital, Division of Infectious Diseases, Boston, United States

17:10
MOAD0105
Abstract
Powerpoint
Slides with audio		Point-of-care CD4 tests can increase life-years saved with reduced costs compared to flow cytometric CD4 counting
Presented by Steven Reid, United Kingdom
C.L. Grundy1, A. Medina Lara2, D. Winogron3, A.P. Croucher3, H.-G. Batz3, T.B. Hallett1, S.D. Reid3
1Imperial College London, London, United Kingdom, 2Bocconi University, Milan, Italy, 3Imperial College London, CD4 Initiative, London, United Kingdom

17:20
Moderated discussion

Powerpoints presentations
Cost comparison of point-of-care and laboratory CD4 testing in resource-limited settings - Ilesh V. Jani

Cost-effectiveness of Xpert MTB RIF for screening for tuberculosis prior to antiretroviral therapy in South Africa - Jason R Andrews

Rapid point-of-care CD4 testing at mobile HIV testing sites to increase linkage to care: an evaluation of a pilot program in South Africa - Bruce Larson

The cost-effectiveness of on-site rapid HIV testing in substance abuse treatment: results of the CTN 0032 randomized trial - Bruce R. Schackman

Point-of-care CD4 tests can increase life-years saved with reduced costs compared to flow cytometric CD4 counting - Steven Reid



Rapporteur report

Track D report by Melissa Neuman


IAS Session Summary. Diagnostics: Innovation, Cost-Effectiveness, and Scale-Up
18 July 2011   
Today’s presentation on innovations and cost-effectiveness of new diagnostic technologies, including point-of-care (POC) CD4 testing , rapid TB testing, and HIV testing in mental health and substance abuse care.
Three presentations presented perspectives on the effectiveness of POC CD4 testing using different methodologies and populations. Jani and colleagues investigated the cost-effectiveness of POC CD4 tests using data from health facilities in 13 sub-Saharan African countries. They found that, given comparable testing volumes, POC and conventional CD4 testing methods had similar costs, and that POC CD4 testing may be most cost-effective at sites where there is high demand for CD4 testing. Reid and colleagues used mathematical models to estimate the impacts of POC CD4 testing on life-years saved and concluded that POC CD4 has similar costs to syndromic management but more potential life years saved. In discussion, one audience participant suggested that alternate outcomes, such as time to treatment initiation, would be useful to consider in cost-effectiveness studies of POC CD4 testing. Finally, Larson and colleagues reported on the results of a pilot study of POC CD4 testing in mobile VCT units in Gauteng province, South Africa, finding that POC CD4-testing improve rates of self-reported care initiation after eight weeks.
Andrews and colleagues evaluated the cost effectiveness of rapid TB testing for clients initiating ART, using a mathematical model to estimate projected life expectancy and cost-effectiveness compared with sputum testing or no testing. They found that rapid testing is generally cost effective in settings with TB prevalence of 10 percent or higher, but in discussion noted that the intervention may be less cost-effective in settings with high prevalence of multi-drug resistant TB because of the high treatment costs for these patients.
Schackman and colleagues noted that HIV testing is often not provided in mental health and substance abuse care in the United States. They presented evidence from a randomized trial of three methods of providing access to testing as part of this care, including a referral to off-site testing, on-site testing, and on-site testing with risk counseling. They found that on-site HIV testing increased test completion and is more cost effective than off-site testing, but that additional counseling was not effective at reducing self-reported risky behaviors.

   

    The organizers reserve the right to amend the programme.
Contact Us | Site map © 2011 International AIDS Society