Background: While new treatment strategies resulted in profound improvements in prognosis of HIV-infection in developed countries, the disease burden is further growing in less developed countries (LDCs). Cost of illness-studies of HIV infection play an important role in modeling the course of HIV infection for performing cost-effectiveness and cost-benefit analyses to allocate financial resources for treatment and prevention worldwide. Objectives: to perform a systematic review of cost of illness studies on HIV infection.

Methods: Searching electronic databases from 01-01-1980 to 30-08-1999 and handsearching of defined journals and ICA abstracts as well as references of reviews and other publications were performed. Studies were included in a database and rated accourding a modified instrument (BMJ 1996) by both authors.

Results: One hundred and seventy-five studies were identified, of whom 154 (in 151 publications) were included in the analysis. Medline search yielded in 84, popline/SF in 15, embase in 3, local databases in 2, handsearching in 19 and searching of references in 32 studies. 66 studies were performed in the US, 4 in Australia, 8 in Canada, 1 in RSA, 54 in Europe, and 21 in LDCs. Only 4 of 68 studies with public sponsoring were done in LDCs. Eighty-three studies reported treatment costs only, 82 studies took the societal perspective. Further data on the specific approach of different countries and the methodological quality of the studies will be presented.

Conclusions: A large number of cost of illness-studies of HIV infection could be identified by handsearching and searching of references. Approach and quality of studies showed wide
variations.