Academic journal article International Perspectives on Sexual and Reproductive Health

Longer Anti-HIV Therapy Is Worth the Cost

Academic journal article International Perspectives on Sexual and Reproductive Health

Longer Anti-HIV Therapy Is Worth the Cost

Article excerpt

Implementation of a new antiretroviral therapy (ART) regimen recommended by the World Health Organization (WHO) for the prevention of mother-to-child transmission of HIV (PMTCT) would be cost-effective, according to an analysis based on a target population of pregnant Nigerian women living with HIV. (1) Each year, there are an estimated 240,000 pregnancies among women in Nigeria living with HIV. At Nigeria's current level of PMTCT coverage (10% of all HIV-infected women), the mother-to-child HIV transmission rate would be 23.7% with the new intervention (i.e., a regimen of three antiretroviral medications for the mother from as early as 14 weeks' gestation through the end of breast-feeding, plus six weeks of ART for the infant), compared with 24.3% with the current standard of care (i.e., a regimen of two antiretroviral medications for the mother from 34 weeks' gestation through seven days postpartum, plus a single dose of ART for the mother and infant during delivery). The difference in rates would amount to 1,440 fewer HIV-infected infants per year and 0.16 fewer disability adjusted life years (DALYs) among infants per pregnancy. If the interventions were implemented at Nigeria's current level of antenatal care coverage (58% of HIV-infected women), the transmission rates would decrease to 13% and 16%, respectively--resulting in 7,680 fewer HIV-infected infants per year and 0. …

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