Lewis R, O'Brien J M, Ray D T, Sibai B M
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
Am J Obstet Gynecol. 1995 Oct;173(4):1329-33. doi: 10.1016/0002-9378(95)91381-5.
Our purpose was to describe the incidence of human immunodeficiency virus infection and to assess the cost/benefit ratio of universal antenatal human immunodeficiency virus screening.
Medical records of women in this urban obstetrics population, from the years 1988 to 1993, were examined. The incidence of known human immunodeficiency virus seropositivity at delivery was determined. The costs of performing human immunodeficiency virus screening, evaluating the disease status, and administering therapy were calculated. These costs were compared with an averaged cost for care and follow-up of infants infected through vertical transmission.
The incidence of known human immunodeficiency virus seropositivity at delivery approximately doubled since the initiation of a human immunodeficiency virus screening program (0.26% to 0.48%). Obstetric screening added an approximate $100,000 to medical costs. The calculated cost of pediatric follow-up of human immunodeficiency virus-seropositive infants for the first 18 months was estimated at $344,355. In our population, with universal screening and zidovudine therapy, the medical costs could be reduced by $175,500 per year.
A program of voluntary human immunodeficiency virus screening increases the incidence of known human immunodeficiency virus infection. Offering screening and follow-up to all pregnant patients in an urban setting is both cost-effective and medically beneficial.
我们的目的是描述人类免疫缺陷病毒感染的发生率，并评估普遍产前人类免疫缺陷病毒筛查的成本效益比。
检查了1988年至1993年该城市产科人群中女性的病历。确定了分娩时已知人类免疫缺陷病毒血清阳性的发生率。计算了进行人类免疫缺陷病毒筛查、评估疾病状况和进行治疗的成本。将这些成本与通过垂直传播感染的婴儿的平均护理和随访成本进行了比较。
自启动人类免疫缺陷病毒筛查计划以来，分娩时已知人类免疫缺陷病毒血清阳性的发生率大约翻了一番（从0.26%升至0.48%）。产科筛查使医疗成本增加了约10万美元。据估计，人类免疫缺陷病毒血清阳性婴儿头18个月的儿科随访计算成本为344,355美元。在我们的人群中，通过普遍筛查和齐多夫定治疗，每年的医疗成本可降低175,500美元。
自愿性人类免疫缺陷病毒筛查计划增加了已知人类免疫缺陷病毒感染的发生率。在城市环境中为所有孕妇提供筛查和随访既具有成本效益又对医学有益。
