Cost effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0450902
Code Inist : 002B02S05. Création : 22/03/2000.