Background::Continuing progress in the global pediatric human immunodeficiency virus (HIV) response depends on timely identification and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design and implementation. This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-effectiveness analyses of HIV EID.Methods::We systematically searched bibliographic databases (Embase, MEDLINE and EconLit) and grey literature for economic analyses of HIV EID in low- and middle-income countries published between January 2008 and June 2021. We extracted data on unit costs, cost savings, and incremental cost-effectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats. We converted unit costs to 2021 USD for easier comparison of costs across studies.Results::After title and abstract screening of 1278 records and full-text review of 99 records, we included 29 studies: 17 cost analyses and 12 model-based cost-effectiveness analyses. Unit costs were 21.46-51.80 USD for point-of-care EID tests and 16.21-42.73 USD for laboratory-based EID tests. All cost-effectiveness analyses stated at least one of the interventions evaluated to be cost-effective. Most studies reported costs of EID testing strategies; however, few studies assessed the same intervention or reported costs in the same way, making comparison of costs across studies challenging. Limited data availability of context-appropriate costs and outcomes of children with HIV as well as structural heterogeneity of cost-effectiveness modelling studies limits generalizability of economic analyses of HIV EID.Conclusions::The available cost and cost-effectiveness evidence for EID of HIV, while not directly comparable across studies, covers a broad range of interventions and suggests most interventions designed to improve EID are cost-effective or cost-saving. Further studies capturing costs and benefits of EID services as they are delivered in real-world settings are needed.

Cost effectiveness;Diagnostics;Low- and middle-income countries;Point of care;Early infant diagnosis;Health systems

Elsbernd Kira;Emmert-Fees Karl M. F.;Erbe Amanda;Ottobrino Veronica;Kroidl Arne;B?rnighausen Till;Geisler Benjamin P.;Kohler Stefan

Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany;Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, Ludwig Maximilian University, Munich, Germany;Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany;Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Munich, Germany;Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany;Department of Health Management and Health Economics, University of Oslo, Oslo, Norway;German Center for Infection Research (DZIF), Partner Site, Munich, Germany;Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA;Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universit?tsmedizin Berlin, Berlin, Germany

贫困所致传染病（英文）

[1]Elsbernd Kira;Emmert-Fees Karl M. F.;Erbe Amanda;Ottobrino Veronica;Kroidl Arne;B?rnighausen Till;Geisler Benjamin P.;Kohler Stefan-.Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review)[J].贫困所致传染病（英文）,2022(04):9-28

EconLit

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