Assessment of HIV testing in blood donations: Cost analysis of routine screening with HIV-antibody and hiv antigen test in Thailand

• Main Author: S. Kongsin
• Other Authors: Mahidol University
• Format: Article
• Published: 2018
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/17655

Objectives: I ) To analyze the cost component of routine screening of Thai blood donors by using HIV-Ab (the 2nd and 3rd Generation ELISA) and HIV-Ag. 2} To determine the cost for the detection of the window period. 3) To analyze the effectiveness of donor's self selection methods. Methods: The study design was a cross-sectional retrospective study using economic tools in quantitative method including epidemiological aspects.The available data from 14 regional/general hospitals in Thailand with high HIV prevalence rates at the provincial level were collected over 30 months.The cost was calculated to present rts present value using a yearly interest rate of 11.5%. Results: The unit cost of HIV-Ab (2nd Gen) was Bant 52, of HIV-Ab (3rd Gen) Baht 58, and of HIV-Ag Baht 81 -The incremental cost of the HIV testing to detect the window period was Bäht 7.004 for HtV-Ab (3rd Gen) and Baht 1,030,740 for HIV-Ag when HIV-Ab test was negative.The positive rate of HIV-Ab (2nd Gen) was 0.39% and HtV-Ab (3rd Gen) 0.48% for 114,877 blood units.The HIV-Ab positive rate among self declared safe donor group (SDS) was 0.51 %, while the self declared non safe group was in contrast 0.93% HIVAb positive. In term of impact to the society was Baht 1.923,780 per unit of transfused blood caused by the distribution of neglected positive blood from the SDS. Conclusion:To ensure the safety of all blood and blood products, selection of safe blood donors by Donor Self Selection Method (DSS) should be considered as the first step in reducing the risk of transmission of HIV through blood. However we emphasized that screening the SDS with 3rd Generation EUSA is essential and cannot be substituted for by DSS.The study will assist the Thai government in estimating the resources needed for routine HIV screening ofThai blood donations.The use of HIV-Ag in screening donated blood was highly costly even after DSS and HIV-Ab screening. Frther evaluation is about the appropriate conditions in detail for using HIV-Ag screening if policy makers want to use this method.