{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:41Z","timestamp":1772169161130,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.16604.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000}}],"reference-count":55,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["204801"],"award-info":[{"award-number":["204801"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020013","name":"NIHR Leicester Biomedical Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020013","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Introduction:<\/ns4:bold>\n                    In lower tuberculosis (TB) incidence countries (&lt;100 cases\/100,000\/year), screening and preventive treatment (PT) for latent TB infection (LTBI) among people living with HIV (PLWH) is often recommended, yet guidelines advising which groups to prioritise for screening can be contradictory and implementation patchy. Evidence of LTBI screening cost-effectiveness may improve uptake and health outcomes at reasonable cost.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    Our systematic review assessed cost-effectiveness estimates of LTBI screening\/PT strategies among PLWH in lower TB incidence countries to identify model-driving inputs and methodological differences. Databases were searched 1980-2020. Studies including health economic evaluation of LTBI screening of PLWH in lower TB incidence countries (&lt;100 cases\/100,000\/year) were included.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Of 2,644 articles screened, nine studies were included. Cost-effectiveness estimates of LTBI screening\/PT for PLWH varied widely, with universal screening\/PT found highly cost-effective by some studies, while only targeting to high-risk groups (such as those from mid\/high TB incidence countries) deemed cost-effective by others. Cost-effectiveness of strategies screening all PLWH from studies published in the past five years varied from US$2828 to US$144,929\/quality-adjusted life-year gained (2018 prices). Study quality varied, with inconsistent reporting of methods and results limiting comparability of studies. Cost-effectiveness varied markedly by screening guideline, with British HIV Association guidelines more cost-effective than NICE guidelines in the UK.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Discussion:<\/ns4:bold>\n                    Cost-effectiveness studies of LTBI screening\/PT for PLWH in lower TB incidence settings are scarce, with large variations in methods and assumptions used, target populations and screening\/PT strategies evaluated. The limited evidence suggests LTBI screening\/PT may be cost-effective for some PLWH groups but further research is required, particularly on strategies targeting screening\/PT to PLWH at higher risk. Standardisation of model descriptions and results reporting could facilitate reliable comparisons between studies, particularly to identify those factors driving the wide disparity between cost-effectiveness estimates.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Registration:<\/ns4:bold>\n                    PROSPERO\n                    <ns4:ext-link xmlns:ns5=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" ns5:href=\"https:\/\/www.crd.york.ac.uk\/PROSPERO\/display_record.php?RecordID=166338\">CRD42020166338<\/ns4:ext-link>\n                    (18\/03\/2020).\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.16604.2","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T10:00:52Z","timestamp":1672912852000},"page":"51","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review"],"prefix":"10.12688","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4688-3924","authenticated-orcid":false,"given":"Rebecca F.","family":"Baggaley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Vegvari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0064-0126","authenticated-orcid":false,"given":"Christian A.","family":"Dimala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-4448","authenticated-orcid":false,"given":"Marc","family":"Lipman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Degtyareva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-3511","authenticated-orcid":false,"given":"Helena A.","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5962-4238","authenticated-orcid":false,"given":"T. D\u00e9irdre","family":"Hollingsworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Pareek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"ref-1","first-page":"149-59","article-title":"Tuberculosis: a global overview of the situation today.","volume":"70","author":"P Sudre","year":"1992","journal-title":"Bull World Health Organ."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"88-95","DOI":"10.1164\/rccm.201308-1480OC","article-title":"Persistent latent tuberculosis reactivation risk in United States immigrants.","volume":"189","author":"N Walter","year":"2014","journal-title":"Am J Respir Crit Care Med."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"CD000171","DOI":"10.1002\/14651858.CD000171.pub3","article-title":"Treatment of latent tuberculosis infection in HIV infected persons.","volume":"2010","author":"C Akolo","year":"2010","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"e243-51","DOI":"10.1016\/S2352-3018(15)00063-6","article-title":"Does antiretroviral therapy reduce HIV-associated tuberculosis incidence to background rates? 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.20730.r53895, Susmita Chatterjee, Department of Research, George Institute for Global Health, New Delhi, Delhi, 06 Feb 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-51\/v2#referee-response-53895","order":0,"name":"referee-response-53895","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.18301.r43486, Richard White, Nicola Foster, TB Modelling Group, TB Centre, Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, 22 Apr 2022, version 1, 2 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-51\/v1#referee-response-43486","order":1,"name":"referee-response-43486","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.20730.r55882, Pete Dodd, School of Health and Related Research, The University of Sheffield, Sheffield, 03 Apr 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-51\/v2#referee-response-55882","order":2,"name":"referee-response-55882","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust through a Wellcome Trust Institutional Strategic Support Fund Fellowship [204801]. MP is supported by a NIHR Development and Skills Enhancement Award and also acknowledges support\/funding from the NIHR Leicester BRC and UKRI. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}