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HIV Screening in Those Over 55 Often Cost-Effective

Results justify the cost in populations with 0.1 percent or more HIV prevalence

WEDNESDAY, June 18 (HealthDay News) -- In tested populations with an HIV prevalence of at least 0.1 percent, it is cost-effective to screen those in the 55 to 75 age group as long as streamlined counseling is offered and screened patients have an at-risk partner, researchers report in the June 17 issue of the Annals of Internal Medicine.

Gillian D. Sanders, Ph.D., of Duke University in Durham, N.C., and colleagues conducted a study to determine the impact of HIV screening for 55- to 75-year-olds versus the current practice by measuring incremental cost-effectiveness, life-years and quality-adjusted life-years (QALYs).

Using a 65-year-old patient as a base case, the investigators found that screening in a population with less than 0.5 percent HIV prevalence using traditional counseling costs $55,440 per QALY for a patient who is not sexually active, but that the cost dropped to $30,020 per QALY among sexually active patients. Using less costly, streamlined counseling, the cost of screening when HIV prevalence was 0.1 percent was less than $60,000 per QALY for patients under the age of 75 with a partner at risk.

"Our analyses suggest that screening decisions in patients older than age 64 years should consider whether partners are at risk, cost, and whether the patient has life-threatening comorbid conditions. Advanced age alone should not preclude screening for HIV," the authors write.

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