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1996-02-27
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Document 0424
DOCN M9630424
TI How much paediatric HIV infection could be prevented by antenatal HIV
testing?
DT 9603
AU Dunn DT; Nicoll A; Holland FJ; Davison CF; Department of Epidemiology
and Biostatistics, Institute of Child; Health, London, United Kingdom.
SO J Med Screen. 1995;2(1):35-40. Unique Identifier : AIDSLINE MED/96091283
AB OBJECTIVE--To estimate the reduction in the number of children infected
with HIV that might be achieved by extending the provision of voluntary
antenatal HIV testing. This effect would be mediated by increased
numbers of women infected with HIV who receive an intervention to reduce
the risk of vertical transmission (for example, zidovudine or caesarean
section delivery), who use an alternative to breast feeding, or whose
pregnancy is terminated. SETTING--London, United Kingdom.
METHODS--Relevant data were derived from neonatal seroprevalence
studies, obstetric and paediatric reporting schemes, and review of
external information. Sensitivity analyses were performed for certain
parameters. RESULTS--Of 106,000 births annually in London, an estimated
169 are to women infected with HIV whose infection is not currently
recognised before pregnancy. An estimated 28-33 children born to these
women will be infected. Precise prediction of the number of paediatric
HIV infections that could be prevented is difficult because of
uncertainty in certain factors, particularly the uptake of antenatal
testing and the efficacy and acceptability of interventions to reduce
prenatal or perinatal transmission. If a testing programme detected 70%
of infected women, none of whom opted for a termination but all of whom
exclusively bottle fed and received an intervention which halved the
risk of transmission, about 12-16 (42-46%) paediatric HIV infections
would be prevented annually. CONCLUSIONS--The estimated cost of
preventing each paediatric infection is high, but this should be seen in
the context of the lifetime health and social care costs for a child
infected with HIV. The feasibility of selective testing should be
considered when formulating policies on antenatal HIV testing.
Programmes that are introduced should be audited to obtain better
estimates of costs and benefits.
DE Bottle Feeding Breast Feeding Cesarean Section Disease Transmission,
Vertical/*PREVENTION & CONTROL Female Human HIV
Infections/DIAGNOSIS/*PREVENTION & CONTROL/TRANSMISSION *HIV
Seroprevalence Infant, Newborn London/EPIDEMIOLOGY Mass Screening
*Models, Statistical Pregnancy *Pregnancy Complications, Infectious
Prenatal Care Probability Risk Factors Support, Non-U.S. Gov't
Zidovudine/THERAPEUTIC USE JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).