For women who come to a medical facility
in labor and without prenatal care, testing and treating with anti-HIV
drugs would prevent HIV infections and save costs in the long-term.
These findings are a result of research done at the UC Medical Center,
and appear in the January/February 2004 issue ofMedical Decision Making.
The study was led by Joseph Mrus, MD,
MSc, assistant professor, and Joel Tsevat, MD, MPH, professor and
director of the Section of Outcomes Research in the Department of
Internal Medicine at UC. In the report, the UC researchers noted that
under currently accepted guidelines, rapid HIV testing and treatment is
recommended for women who come to a medical facility in labor but
without prenatal care.
“Although rapid HIV testing and treatment
is recommended, the optimal drug regimen to use is controversial, and
the feasibility of testing at sites where there are few women without
prenatal care and/or the rate of HIV infection is low is unclear,” said
Using simulation modeling, results of
this study showed that for women in labor without prenatal care,
testing for HIV and administering drug therapy to the women who test
positive is cost-effective. Treating the women for HIV during labor,
without HIV testing first, was also cost effective in preventing
transmission of HIV from mother to child and may be a reasonable
strategy at sites where rapid HIV testing is not possible or practical.
Additionally, the UC researchers concluded that using two or three
anti-HIV drug regimens, although more expensive, is likely to be more
cost effective in the long-term than a standard single drug regimen.