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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



NEWS AND NEW DEVELOPMENTS



Cost-Effectiveness of Cesarean Section Delivery to Prevent Mother-to-Child Transmission of HIV-1 [MT Halpern, et al. AIDS 2000;14:691]: The authors performed a cost analysis of cesarean section plus AZT compared to vaginal delivery in HIV-infected women receiving HAART. Results are shown in the following table:

Cost-Effectiveness of C-Section to Prevent Perinatal Transmission of HIV
  C-section + AZT HAART
Cost/case avoided $1,131 $112,693
Cost/year life saved $17 $1,697

Comment: This study shows dramatic benefits for C-section in reducing the cost of HIV care. It should be acknowledged that cost-analyses of medical strategies are highly dependent on the data used for the model, and the results shown are highly variable depending on vertical transmission rates. The authors conclude that elective cesarean section could prevent 239 pediatric HIV-cases/year in the U.S. The U.S. Public Health Service/DHHS Panel on use of antiretroviral in pregnancy has not taken a stand regarding the C-section question, but this issue is high on the panel's priority list. posted 5/25/2000





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