Consolidated guidelines on HIV testing services, 2019: web annex F. Modelling the cost-effectiveness of maternal HIV retesting in high- and low-HIV burden settings (abstract)
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World Health Organization
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2 p.
This Web Annex accompanies the Consolidated guidelines on HIV testing services, 2019 and presents an abstract describing a modelling study evaluating the cost–effectiveness of maternal HIV retesting during late pregnancy and the postpartum period in settings with different HIV burdens. Using Markov models, the analysis assesses the health and economic impact of alternative retesting strategies in Kenya, South Africa, Colombia and Ukraine, with the aim of informing recommendations to prevent mother-to-child transmission of HIV. The study compares different retesting schedules from late pregnancy through nine months postpartum, estimating their effects on infant HIV infections, disability-adjusted life years (DALYs), programme costs and incremental cost–effectiveness. The publication summarizes findings indicating that a single HIV retest during late pregnancy, with catch-up testing through six weeks postpartum, is the most cost-effective strategy in high HIV burden settings, preventing a substantial proportion of infant HIV infections attributable to incident maternal infection. Additional postpartum retesting provides only marginal incremental benefits at considerably higher cost, while no evaluated retesting strategy is cost-effective in the low-prevalence settings examined. Intended as a technical companion to the main guideline, the annex provides modelling evidence supporting WHO recommendations on maternal HIV retesting and promotes transparency in the guideline development process.
This Web Annex accompanies the Consolidated guidelines on HIV testing services, 2019 and presents an abstract describing a modelling study evaluating the cost–effectiveness of maternal HIV retesting during late pregnancy and the postpartum period in settings with different HIV burdens. Using Markov models, the analysis assesses the health and economic impact of alternative retesting strategies in Kenya, South Africa, Colombia and Ukraine, with the aim of informing recommendations to prevent mother-to-child transmission of HIV. The study compares different retesting schedules from late pregnancy through nine months postpartum, estimating their effects on infant HIV infections, disability-adjusted life years (DALYs), programme costs and incremental cost–effectiveness. The publication summarizes findings indicating that a single HIV retest during late pregnancy, with catch-up testing through six weeks postpartum, is the most cost-effective strategy in high HIV burden settings, preventing a substantial proportion of infant HIV infections attributable to incident maternal infection. Additional postpartum retesting provides only marginal incremental benefits at considerably higher cost, while no evaluated retesting strategy is cost-effective in the low-prevalence settings examined. Intended as a technical companion to the main guideline, the annex provides modelling evidence supporting WHO recommendations on maternal HIV retesting and promotes transparency in the guideline development process.