| Routine prenatal screening for HIV in a low-prevalence setting. | |
MedLine Citation:
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PMID: 9834719 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The objectives of this study were to assess the effect of British Columbia's June 1994 guidelines for prenatal HIV screening on the rate of maternal-fetal HIV transmission and to estimate the cost-effectiveness of such screening. METHODS: The authors conducted a retrospective review of pregnancy and delivery statistics, HIV screening practices, laboratory testing volume, prenatal and labour management decisions of HIV-positive women, maternal-fetal transmission rates and associated costs. RESULTS: Over 1995 and 1996, 135,681 women were pregnant and 92,645 carried to term. The rate of HIV testing increased from 55% to 76% of pregnancies on chart review at one hospital between November 1995 and November 1996. On the basis of seroprevalence studies, an estimated 50.2 pregnancies and 34.3 (95% confidence interval 17.6 to 51.0) live births to HIV-positive women were expected. Of 42 identified mother-infant pairs with an estimated date of delivery during 1995 or 1996, 25 were known only through screening. Of these 25 cases, there were 10 terminations, 1 spontaneous abortion and 14 cases in which the woman elected to carry the pregnancy to term with antiretroviral therapy. There was one stillbirth. One instance of maternal-fetal HIV transmission occurred among the 13 live births. The net savings attributable to prevented infections among babies carried to term were $165,586, with a saving per prevented case of $75,266. INTERPRETATION: A routine offer of pregnancy screening for HIV in a low-prevalence setting reduces the rate of maternal-fetal HIV transmission and may rival other widely accepted health care expenditures in terms of cost-effectiveness. |
Authors:
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D M Patrick; D M Money; J Forbes; S R Dobson; M L Rekart; D A Cook; P J Middleton; D R Burdge |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne Volume: 159 ISSN: 0820-3946 ISO Abbreviation: CMAJ Publication Date: 1998 Oct |
Date Detail:
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Created Date: 1998-12-11 Completed Date: 1998-12-11 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9711805 Medline TA: CMAJ Country: CANADA |
Other Details:
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Languages: eng Pagination: 942-7 Citation Subset: AIM; IM; N; X |
Affiliation:
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British Columbia Centre for Disease Control Society, Vancouver. david.patrick@bccdc.hnet.bc.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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British Columbia
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epidemiology Canada Cost-Benefit Analysis Female HIV Infections / diagnosis*, epidemiology, ethnology, prevention & control*, transmission Humans Infectious Disease Transmission, Vertical / prevention & control* Mass Screening* / economics, statistics & numerical data Pregnancy Pregnancy Complications, Infectious / diagnosis*, epidemiology, ethnology, virology Prenatal Care* / economics, statistics & numerical data Prevalence Retrospective Studies Risk Factors |
| Comments/Corrections | |
Comment In:
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CMAJ. 1999 May 4;160(9):1286-7
[PMID:
10333827
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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