AI Article Synopsis

  • In 2010, WHO updated guidelines aimed at preventing mother-to-child transmission of HIV, prompting a study on their effectiveness in Zimbabwe.
  • Using a computer model, researchers simulated different PMTCT treatment options for HIV-positive pregnant women and analyzed the resulting life expectancy and healthcare costs.
  • Findings showed that newer treatment options (Options A, B, and B+) not only improved health outcomes for mothers and infants but also reduced long-term costs compared to the older sdNVP regimen, with Option B+ offering the best health benefits for a reasonable cost.

Article Abstract

Background: In 2010, the World Health Organization (WHO) released revised guidelines for prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). We projected clinical impacts, costs, and cost-effectiveness of WHO-recommended PMTCT strategies in Zimbabwe.

Methods: We used Zimbabwean data in a validated computer model to simulate a cohort of pregnant, HIV-infected women (mean age, 24 years; mean CD4 count, 451 cells/µL; subsequent 18 months of breastfeeding). We simulated guideline-concordant care for 4 PMTCT regimens: single-dose nevirapine (sdNVP); WHO-recommended Option A, WHO-recommended Option B, and Option B+ (lifelong maternal 3-drug antiretroviral therapy regardless of CD4). Outcomes included maternal and infant life expectancy (LE) and lifetime healthcare costs (2008 US dollars [USD]). Incremental cost-effectiveness ratios (ICERs, in USD per year of life saved [YLS]) were calculated from combined (maternal + infant) discounted costs and LE.

Results: Replacing sdNVP with Option A increased combined maternal and infant LE from 36.97 to 37.89 years and would reduce lifetime costs from $5760 to $5710 per mother-infant pair. Compared with Option A, Option B further improved LE (38.32 years), and saved money within 4 years after delivery ($5630 per mother-infant pair). Option B+ (LE, 39.04 years; lifetime cost, $6620 per mother-infant pair) improved maternal and infant health, with an ICER of $1370 per YLS compared with Option B.

Conclusions: Replacing sdNVP with Option A or Option B will improve maternal and infant outcomes and save money; Option B increases health benefits and decreases costs compared with Option A. Option B+ further improves maternal outcomes, with an ICER (compared with Option B) similar to many current HIV-related healthcare interventions.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540037PMC
http://dx.doi.org/10.1093/cid/cis858DOI Listing

Publication Analysis

Top Keywords

maternal infant
20
option option
16
compared option
16
option
14
mother-infant pair
12
health organization
8
guidelines prevention
8
prevention mother-to-child
8
hiv transmission
8
who-recommended option
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!