The economic burden to families of HIV and HIV/tuberculosis coinfection in a subsidized HIV treatment program

Abstract

Introduction: The high cost of antiretroviral (ARV) drugs has led to the initiation of subsidized HIV treatment programs in developing countries. The care of tuberculosis (TB), a common opportunistic infection, is not built into the subsidized program. The current study was done to evaluate the cost burden of HIV/AIDS, TB, and TB and HIV/AIDS coinfections to the family.

Subjects and methods: The study was carried out in the consultant outpatient department of the University of Benin Teaching Hospital in Nigeria. Consecutive families with 21 family member managed for HIV and or TB were recruited into three cohorts of HIV only, TB only and HIV/TB cohorts. The average monthly costs of treatment, transportation family income and percentage of income spent on care were computed for each family. The average monthly man-hours per family spent on clinic visitation were determined.

Results: A total of 61 families consisting of 128 family members met the study criteria. The mean cost of treatment per month was significantly higher in families in the HIV/TB cohort than in other cohorts, P = 0.0001. The mean percentage of income spent on treatment was significantly higher in the HIV/TB cohort compared to other cohorts, P = 0.0001.

Conclusion: The cost of managing TB/HIV coinfection significantly increased the costs to the families in the subsidized HIV treatment program. It is recommended that a comprehensive package of subsidized HIV care that is inclusive of TB treatment and care for other comorbidities be initiated in developing countries.