Number, type and cost of microbiological tests during HIV Pre-Exposure Prophylaxis: The experience of a French hospital.
Adult
Anti-HIV Agents
/ therapeutic use
Bacteriological Techniques
/ economics
Chlamydia trachomatis
/ isolation & purification
Female
France
HIV Infections
/ prevention & control
Hospitals
Humans
Male
Microbiological Techniques
/ economics
Neisseria gonorrhoeae
/ isolation & purification
Pre-Exposure Prophylaxis
/ methods
Retrospective Studies
Sexual Behavior
Sexually Transmitted Diseases
/ microbiology
Virology
/ economics
HIV
Microbiological assays
PrEP
Sexually transmitted diseases
Journal
Infectious diseases now
ISSN: 2666-9919
Titre abrégé: Infect Dis Now
Pays: France
ID NLM: 101775152
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
12
05
2020
revised:
09
06
2020
accepted:
14
10
2020
pubmed:
24
10
2020
medline:
8
10
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
Microbiological tests are required for individuals on HIV Pre-Exposure Prophylaxis (PrEP), but their real-life numbers, types and cost are poorly described. Number, type, and results of microbiological tests performed in a Besançon Hospital-associated laboratory, France, from 2016 to 2019, in the setting of PrEP consultations were retrospectively collected. Costs were estimated by the current reimbursement rate set by the French national protection system. 756 consultations for PrEP initiation or follow-up of 135 persons were performed over 4 years. Among 3434 tests performed in the institution-associated laboratory, 1083 and 2351 were virological and bacteriological tests, respectively. Serology was predominant in virology (98% of virological tests), with HIV, HCV, and HBV screening as the 3 more frequent assays, whereas molecular biology was predominant in bacteriology (63.1% of bacteriological tests) with N. gonorrhoeae and C. trachomatis screening as leader assays. Agar-based culture accounted for 1% of bacterial tests. The global cost of microbiological tests was 45,983.20 euros, corresponding to a mean cost of 60.80 euros per consultation. Virological and bacteriological tests accounted for 37.7% and 62.3% of this budget, respectively. No seroconversion was observed for HIV or HCV. N. gonorrhoeae and C. trachomatis were detected at least once in 39.3% and 22.4% of individuals, respectively, with 15% of symptomatic episodes in both cases. Active syphilis infection was detected in 15.4% of individuals. Since numerous microbiological tests are required during PrEP, the availability of specific technical platforms should not be neglected by centers wishing to set up PrEP consultations.
Sections du résumé
BACKGROUND
BACKGROUND
Microbiological tests are required for individuals on HIV Pre-Exposure Prophylaxis (PrEP), but their real-life numbers, types and cost are poorly described.
METHODS
METHODS
Number, type, and results of microbiological tests performed in a Besançon Hospital-associated laboratory, France, from 2016 to 2019, in the setting of PrEP consultations were retrospectively collected. Costs were estimated by the current reimbursement rate set by the French national protection system.
RESULTS
RESULTS
756 consultations for PrEP initiation or follow-up of 135 persons were performed over 4 years. Among 3434 tests performed in the institution-associated laboratory, 1083 and 2351 were virological and bacteriological tests, respectively. Serology was predominant in virology (98% of virological tests), with HIV, HCV, and HBV screening as the 3 more frequent assays, whereas molecular biology was predominant in bacteriology (63.1% of bacteriological tests) with N. gonorrhoeae and C. trachomatis screening as leader assays. Agar-based culture accounted for 1% of bacterial tests. The global cost of microbiological tests was 45,983.20 euros, corresponding to a mean cost of 60.80 euros per consultation. Virological and bacteriological tests accounted for 37.7% and 62.3% of this budget, respectively. No seroconversion was observed for HIV or HCV. N. gonorrhoeae and C. trachomatis were detected at least once in 39.3% and 22.4% of individuals, respectively, with 15% of symptomatic episodes in both cases. Active syphilis infection was detected in 15.4% of individuals.
CONCLUSIONS
CONCLUSIONS
Since numerous microbiological tests are required during PrEP, the availability of specific technical platforms should not be neglected by centers wishing to set up PrEP consultations.
Identifiants
pubmed: 33096202
pii: S0399-077X(20)30757-5
doi: 10.1016/j.medmal.2020.10.017
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
357-361Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.