Epidemiological and pharmacoeconomic aspects of HIV infection in military
The goals of the research are to determine the latent morbidity and financial losses of the Russian Ministry of Defense due to the dismissal of service members with HIV infection at symptomatic stages; to establish the supposed clinical and pharmacoeconomic effectiveness of the early detection and t...
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| Format: | Article |
| Language: | Russian |
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Journal Infectology
2021-03-01
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| Series: | Журнал инфектологии |
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| Online Access: | https://journal.niidi.ru/jofin/article/view/1183 |
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| author | Yu. I. Bulankov M. A. Bulygin A. V. Bespalov K. V. Zhdanov A. A. Murachev K. S. Ivanov Yu. I. Lyashenko |
| author_facet | Yu. I. Bulankov M. A. Bulygin A. V. Bespalov K. V. Zhdanov A. A. Murachev K. S. Ivanov Yu. I. Lyashenko |
| author_sort | Yu. I. Bulankov |
| collection | DOAJ |
| description | The goals of the research are to determine the latent morbidity and financial losses of the Russian Ministry of Defense due to the dismissal of service members with HIV infection at symptomatic stages; to establish the supposed clinical and pharmacoeconomic effectiveness of the early detection and treatment of service members.The materials compile 379 case histories of patients of the only specialized department for HIV-positive military personnel in the Armed Forces for 2017–2019, as well as various reporting forms. The study uses the following methods for the analysis: Markov chains are employed to calculate QALYs (Quality Adjusted Life Years), “cost-effectiveness”, and “willingness to pay”. The research compares two competitive models: “Current Situation” - without the introduction of algorithms for early detection and treatment of HIV infection, and “Prognosis” - with the introduction of these algorithms.The following results are obtained: implementing a mandatory triennial screening for HIV-antibodies among military personnel allows to raise the detection of HIV-positive military personnel in the early stages of the disease by 55%. At the same time, early administered antiretroviral therapy prevents the progression of HIV infection, while the number of military personnel who have reached symptomatic stages of HIV infection and the number of deaths decreases by 35,6% and 80,2% (six-fold), respectively. The economic effectiveness of these measures includes a reduced cost of treatment and an increased length of military service. The sensitivity analysis of the method shows that the proposed measures remain pharmacoeconomically highly effective with a wide variability of the initial data.Conclusion. The results of the study demonstrate that a significant improvement of the epidemiological situation in the field of HIV infection in the Armed Forces is achievable at very low economic costs. With the full implementation of the proposed measures, the cohort of military personnel of the Armed Forces is able to achieve the World Health Organization’s “90-90-90”criteria of in 3–5 years. |
| format | Article |
| id | doaj-art-2adeb78d5b65458d954b2cdc28009e05 |
| institution | Kabale University |
| issn | 2072-6732 |
| language | Russian |
| publishDate | 2021-03-01 |
| publisher | Journal Infectology |
| record_format | Article |
| series | Журнал инфектологии |
| spelling | doaj-art-2adeb78d5b65458d954b2cdc28009e052025-08-20T04:00:18ZrusJournal InfectologyЖурнал инфектологии2072-67322021-03-011319310110.22625/2072-6732-2021-13-1-93-101895Epidemiological and pharmacoeconomic aspects of HIV infection in militaryYu. I. Bulankov0M. A. Bulygin1A. V. Bespalov2K. V. Zhdanov3A. A. Murachev4K. S. Ivanov5Yu. I. Lyashenko6Military Medical Academy named after S.M. KirovMilitary Medical Academy named after S.M. KirovNational Medical Research Center of Oncology named after N.N. PetrovMilitary Medical Academy named after S.M. Kirov1586 Military Clinical HospitalMilitary Medical Academy named after S.M. KirovMilitary Medical Academy named after S.M. KirovThe goals of the research are to determine the latent morbidity and financial losses of the Russian Ministry of Defense due to the dismissal of service members with HIV infection at symptomatic stages; to establish the supposed clinical and pharmacoeconomic effectiveness of the early detection and treatment of service members.The materials compile 379 case histories of patients of the only specialized department for HIV-positive military personnel in the Armed Forces for 2017–2019, as well as various reporting forms. The study uses the following methods for the analysis: Markov chains are employed to calculate QALYs (Quality Adjusted Life Years), “cost-effectiveness”, and “willingness to pay”. The research compares two competitive models: “Current Situation” - without the introduction of algorithms for early detection and treatment of HIV infection, and “Prognosis” - with the introduction of these algorithms.The following results are obtained: implementing a mandatory triennial screening for HIV-antibodies among military personnel allows to raise the detection of HIV-positive military personnel in the early stages of the disease by 55%. At the same time, early administered antiretroviral therapy prevents the progression of HIV infection, while the number of military personnel who have reached symptomatic stages of HIV infection and the number of deaths decreases by 35,6% and 80,2% (six-fold), respectively. The economic effectiveness of these measures includes a reduced cost of treatment and an increased length of military service. The sensitivity analysis of the method shows that the proposed measures remain pharmacoeconomically highly effective with a wide variability of the initial data.Conclusion. The results of the study demonstrate that a significant improvement of the epidemiological situation in the field of HIV infection in the Armed Forces is achievable at very low economic costs. With the full implementation of the proposed measures, the cohort of military personnel of the Armed Forces is able to achieve the World Health Organization’s “90-90-90”criteria of in 3–5 years.https://journal.niidi.ru/jofin/article/view/1183hiv-infectionmilitary servicemilitary personnelqalyhrqolcost-effectiveness analysiswillingness to paymarkov’s chain |
| spellingShingle | Yu. I. Bulankov M. A. Bulygin A. V. Bespalov K. V. Zhdanov A. A. Murachev K. S. Ivanov Yu. I. Lyashenko Epidemiological and pharmacoeconomic aspects of HIV infection in military Журнал инфектологии hiv-infection military service military personnel qaly hrqol cost-effectiveness analysis willingness to pay markov’s chain |
| title | Epidemiological and pharmacoeconomic aspects of HIV infection in military |
| title_full | Epidemiological and pharmacoeconomic aspects of HIV infection in military |
| title_fullStr | Epidemiological and pharmacoeconomic aspects of HIV infection in military |
| title_full_unstemmed | Epidemiological and pharmacoeconomic aspects of HIV infection in military |
| title_short | Epidemiological and pharmacoeconomic aspects of HIV infection in military |
| title_sort | epidemiological and pharmacoeconomic aspects of hiv infection in military |
| topic | hiv-infection military service military personnel qaly hrqol cost-effectiveness analysis willingness to pay markov’s chain |
| url | https://journal.niidi.ru/jofin/article/view/1183 |
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