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  1. Cost effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa.

    Article - En anglais

    Background Identification of economical interventions to decrease HIV-1 transmission to children is an urgent public-health priority in sub-Saharan Africa.

    We assessed the cost effectiveness of the HIVNET 012 nevirapine regimen.

    Methods We assessed cost effectiveness in a hypothetical cohort of 20000 pregnant women in sub-Saharan Africa.

    Our main outcome measures were programme cost, paediatric HIV-1 cases averted, cost per case averted, and cost per disability-adjusted life-year (DALY).

    We compared HIVNET 012 with other short-course antiretroviral regimens.

    We also compared two implementation strategies : counselling and HIV-1 testing before treatment (targeted treatment), or nevirapine for all pregnant women (universal treatment, no counselling and testing).

    We did univariate and multivariate sensitivity analyses.

    Findings For universal treatment with 30% HIV-1 seroprevalence, the HIVNET 012 regimen would avert 603 cases of HIV-1 in babies, cost US$83 333, and generate 15862 DALYs.

    The associated cost-effectiveness ratios were $138 per case averted or $5.25 per DALY.

    At 15% seroprevalence, the universal treatment option would cost $83 333 and avert 302 cases at $276 per case averted or $10.51 per DALY.

    For targeted treatment at 30% seroprevalence, HIVNET 012 would cost $141 922 and avert 476 cases at $298 per case averted or $11.29 per DALY. (...)

    Mots-clés Pascal : SIDA, Virose, Infection, Virus HIV1, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Transmission verticale, Névirapine, Antiviral, Chimioprophylaxie, Traitement, Prévention, Inhibiteur enzyme, RNA-directed DNA polymerase, Nucleotidyltransferases, Transferases, Enzyme, Dose unique, Analyse coût efficacité, Homme, Femelle, Gestation, Nouveau né, Economie santé, Afrique subsaharienne, Afrique, Immunopathologie, Immunodéficit, Gestation pathologie, Nouveau né pathologie

    Mots-clés Pascal anglais : AIDS, Viral disease, Infection, HIV-1 virus, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Vertical transmission, Nevirapine, Antiviral, Chemoprophylaxis, Treatment, Prevention, Enzyme inhibitor, RNA-directed DNA polymerase, Nucleotidyltransferases, Transferases, Enzyme, Single dose, Cost efficiency analysis, Human, Female, Pregnancy, Newborn, Health economy, Sub-Saharan Africa, Africa, Immunopathology, Immune deficiency, Pregnancy disorders, Newborn diseases

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0450902

    Code Inist : 002B02S05. Création : 22/03/2000.