HEALTH-CARE AND ITS COSTS FOR CHILDREN WITH PERINATALLY ACQUIRED HIV-INFECTION

Objective: To describe survival patterns, use of health services and r elated costs for Australian children with perinatally acquired human i mmunodeficiency virus (HIV) infection. Methodology: A retrospective cr oss-sectional survey was made of 20 children with HIV infection (91% o f those diagnosed) and 13 children with maternal antibodies who subseq uently seroreverted, treated at 10 medical centres. Details of disease progression and use of health services were obtained from hospital me dical records. Monthly costs for three phases of infection were estima ted by linking service usage rates with estimates of the unit cost of each service. The average lifetime cost was estimated by combining mon thly costs and phase duration estimates from the literature. Results: Patterns of disease progression were similar to those reported interna tionally, with a median survival of 8 years. Use of health services in creased with severity of illness. Mean monthly costs were $120 per mon th (1992 Australian dollars) for children with maternal antibodies who subsequently seroreverted, $320 per month for children with HIV infec tion but no acquired immunodeficiency syndrome (AIDS)-defining illness , and $1830 per month for children with AIDS. The present value of tot al lifetime cost for a child with HIV infection was $48174, 46% of whi ch was for treatment of AIDS. Discussion: The mean lifetime cost for a perinatally infected child was just over half that for a man with HIV in Australia. Health service usage and costs were lower for Australia n than American children with HIV.