A5061118173- HIV/AIDS Research and Interventions
- HIV-related health complications and treatments
- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- Pharmaceutical Economics and Policy
- Health Systems, Economic Evaluations, Quality of Life
- HIV, Drug Use, Sexual Risk
- HIV/AIDS Impact and Responses
- Adolescent Sexual and Reproductive Health
- Adolescent and Pediatric Healthcare
- Tuberculosis Research and Epidemiology
- Chronic Disease Management Strategies
- Hepatitis B Virus Studies
- Child and Adolescent Health
- Liver Disease Diagnosis and Treatment
- Mycobacterium research and diagnosis
- Viral-associated cancers and disorders
- Hepatitis C virus research
- Economic and Environmental Valuation
- demographic modeling and climate adaptation
- Pneumocystis jirovecii pneumonia detection and treatment
Massachusetts General Hospital
2013-2024
Brigham and Women's Hospital
2013-2017
Harvard University
2013-2017
Cornell University
2013
Yale University
2013
Chinese translation Background: U.S. HIV treatment guidelines recommend branded once-daily, 1-pill efavirenz–emtricitabine–tenofovir as first-line antiretroviral therapy (ART). With the anticipated approval of generic efavirenz in United States, a 3-pill alternative (generic efavirenz, lamivudine, and tenofovir) will decrease cost but may reduce adherence virologic suppression. Objective: To assess clinical effect, costs, cost-effectiveness 3-pill, generic-based regimen compared with...
Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is evaluate the clinical and economic impact of point-of-care compared laboratory-based Mozambique.We use a validated model testing, linkage, treatment (CEPAC-International) examine two strategies immunological staging Mozambique: (1) testing (LAB-CD4) (2) (POC-CD4). Model outcomes include 5-y survival, life expectancy, lifetime costs, incremental cost-effectiveness ratios...
Importance Prevalence of chronic hepatitis C virus (HCV) infection among pregnant people is increasing in the US. HCV transmitted vertically 7% to 8% births. Direct-acting antiviral (DAA) therapy was recently approved for children with who are 3 years or older. The clinical and economic impacts early DAA young HCV, compared treating at older ages, unknown. Objective To develop a state-transition model project outcomes perinatally acquired investigate cost-effectiveness various ages. Design,...
Understanding HIV transmission dynamics is critical to estimating the potential population-wide impact of prevention and treatment interventions. We developed an individual-based simulation model heterosexual epidemic in South Africa linked it previously published Cost-Effectiveness Preventing AIDS Complications (CEPAC) International Model, which simulates natural history HIV. In this new model, CEPAC Dynamic Model (CDM), probability per sexual encounter between short-term, long-term...
Abstract Background A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and cost than the first-generation AlereLAM assay. We evaluated cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective symptoms. Methods used a microsimulation model to project clinical economic outcomes 3 strategies: (1) sputum Xpert MTB/RIF (Xpert), (2) plus (Xpert+AlereLAM), (3) (Xpert+FujiLAM). The modeled cohort...
Computer-based simulation models serve an important purpose in informing HIV care for children and adolescents. We review current model-based approaches to pediatric adolescent estimates guidelines.Clinical disease epidemiologic are used inform global regional of numbers adolescents living with need antiretroviral therapy, develop normative guidelines addressing strategies diagnosis treatment children, forecast future therapy formulations commodities. To improve model-generated policy...
The most effective treatment for advanced AIDS-associated Kaposi sarcoma is paclitaxel or pegylated liposomal doxorubicin (PLD); neither routinely used in sub-Saharan Africa due to limited availability and high cost. We examined the clinical impact, costs, cost-effectiveness of PLD Kenya, compared with etoposide bleomycin-vincristine.In this study, we use Cost-Effectiveness Preventing AIDS Complications (CEPAC)-International Model project outcomes costs among people living HIV on...
To examine the clinical and economic value of point-of-care CD4 (POC-CD4) or viral load monitoring compared with current practices in Mozambique, a country representative diverse resource limitations encountered by HIV treatment programs sub-Saharan Africa.
Background. The expected value of sample information (EVSI) can help prioritize research but its application is hampered by computational infeasibility, especially for complex models. We investigated an approach Strong and colleagues to estimate EVSI applying generalized additive models (GAM) results generated from a probabilistic sensitivity analysis (PSA). Methods. For 3 potential HIV prevention treatment strategies, we estimated life expectancy lifetime costs using the Cost-effectiveness...
Metamodels can simplify complex health policy models and yield instantaneous results to inform decisions. We investigated the predictive validity of linear regression metamodels used support a real-time decision-making tool that compares infant HIV testing/screening strategies.
AbstractAbstractBackground: Several cluster-randomized HIV prevention trials aim to demonstrate the population-level preventive impact of antiretroviral therapy (ART). 2013 World Health Organization (WHO) guidelines raising ART initiation threshold CD4 <500/µL could attenuate these trials’ effect size by increasing usage in control clusters. Methods: We used a computational model simulate strategies from hypothetical trial. The primary outcome was relative reduction 24-month incidence...
Value of Information (VOI) analysis examines whether to acquire information before making a decision. We introduced VOI the HIV audience, using example generic antiretroviral therapy (ART) in US.We used mathematical model and probabilistic sensitivity (PSA) generate probability distributions survival (in quality-adjusted life years, QALYs) cost for three potential first-line ART regimens: three-pill generic, two-pill single-pill branded. These served as input comparison two hypothetical...
Objectives. Conventional value-of-information (VOI) analysis assumes complete uptake of an optimal decision. We employed extended framework that includes value-of-implementation (VOM)-the benefit encouraging adoption strategy-and estimated how future trials diagnostic tests for HIV-associated tuberculosis could improve public health decision making and clinical economic outcomes. Methods. evaluated the outcomes costs, given current information, 3 screening strategies among hospitalized...
Men who have sex with men (MSM) on antiretroviral therapy (ART) are at risk for multimorbidity as life expectancy increases. Simulation models can project population sizes and age distributions to assist health policy planning.We populated the CEPAC-US model CDC data HIV epidemic among MSM in United States. The PEARL was predominantly informed by NA-ACCORD (20092017). We compared projected of receiving ART (20212031) investigated how parameters assumptions affected results.We an aging...