AEGiS-15IAC: TRICAM: Medico-economic pilot study on HAART for HIV-infected patients in a private company of Cameroon.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

TRICAM: Medico-economic pilot study on HAART for HIV-infected patients in a private company of Cameroon.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1024)

Guiard-Schmid JB, Montagut B, Ribadeau-Dumas F, Edoo Edoo G, Makong S, Bidjeck M, Marechal E, Nerrienet E, Chevallier-Schwartz M, Buclez B, Longuet C, Le Pen C, Pialoux G, Rozenbaum W
Hopital Tenon, Paris, France

BACKGROUND: TRICAM study was a pilot ARV access program to demonstrate feasibility and cost effectiveness of HAART in the private company ALUCAM (aluminum production in Edea, Cameroon). This company had previously set up a global HIV management program for employees and families, including prevention, information, Voluntary Counseling and Testing (VCT), treatment of opportunistic infections and psychological support.

METHODS: Prospective study in HIV-infected naïve adult patients to assess clinical and biological efficacy of AZT + 3TC + EFV and cost-benefit ratio of HAART (comparison before/after for each pt).

RESULTS: 26 pts included (50% women) and follow-up of 48 weeks. Median age = 40.6 [26-53], 73.1% of pts had had AIDS defining illness. [table: see text] 40.1% of efavirenz associated neurological disorders, 1 transient grade 3 liver toxicity, 1 grade 4 anemia and 2 deaths (1 lymphoma, 1 unexplained cause) occurred. 10 pts gave up treatment (4 before W8, 6 after W24) without adverse event, under family or traditional healers influence. Among 20 pts studied, direct costs (hospitalizations, visits, transports, analysis & treatments) increased regularly during the 2 years before HAART. When HAART started, direct costs were stabilized at 1594 $/pt-year (at 2002 ARV prices) and absenteeism decreased (46.6 to 32.5 days/semester). Other costs (productivity loss, funerals, workers replacement, etc.) cannot be evaluated in this small study. Conclusion HAART efficacy and tolerance is comparable to previous experiences, even drop out rate remains high. There is still employees' reluctance in this setting to get treatment (fear of discrimination & confidentiality breach). In the area of HAART, the company health expenses are stabilized at 1590 $/patient-year and absenteeism decreased. VCT was boosted by TRICAM study. During 7 years of HIV management program, survey among ALUCAM workers showed a remarkably low HIV prevalence (3.2% in 2003), whereas the overall prevalence in Cameroon is estimated at 12%.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Antiretroviral Therapy, Highly Active, HIV, HIV Seropositivity, Pilot Projects, HIV Infections, Prevalence, Anti-HIV Agents, Disease Progression, HIV-1, HIV Protease Inhibitors, Cost-Benefit Analysis, Hospitalization, Prospective Studies, Cameroon, Humans, Female, Adult, economics, therapy, drug therapy

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