Document Detail


Routine prenatal screening for HIV in a low-prevalence setting.
MedLine Citation:
PMID:  9834719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  1998-12-11     Completed Date:  1998-12-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  942-7     Citation Subset:  AIM; IM; N; X    
Affiliation:
British Columbia Centre for Disease Control Society, Vancouver. david.patrick@bccdc.hnet.bc.ca
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MeSH Terms
Descriptor/Qualifier:
British Columbia / 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:
CMAJ. 1999 May 4;160(9):1286-7   [PMID:  10333827 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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