艾滋病不同流行区防治母婴传播的策略研究：基于卫生经济学评价的证据

摘要

Objective Through analyzing the published article to investigate cost-effectiveness,cost-benefit and cost-utility evidence of mother-to-child transmission of HIV/AIDS in low and middle income countries. Methods Reviewed published during the year of 1994-1995 on low and middle income countries to pre-vent mother-to-child transmission of HIV economics evaluation through analyzing cost-effectiveness cost-benefit and cost-utility of the different countries,extracted and integratied the data.Results 13 article fo-cuses on the cost-effectiveness,3 articles reserched the cost-utillity,9 articles reserched the cost-effective-ness and cost-utillity.Conclusion In low and middle-income countries,the best prevention measure of mother-to-child transmission with HIV cost-effectbest interventions is voluntary counseling and testing (VCT)HIV-NET012/ACTG076 used in Mexico pregnant women.The best intervention of cost-uility ACTG076 28 weeks+HIVNET012+hiv-positive children of antiretroviral therapy (art)used in South Af-rica′s use pregnant women.The use of drugs is the best intervention measures for the cost-effectiveness and cost-utility,and preferably used in the 1 w postpartum.%目的：通过综合分析已发表的文献，探讨低收入和中等收入国家预防艾滋病母婴传播的成本-效果、成本-效用与成本-效益。方法回顾1994年-2015年期间已发表的有关低收入和中等收入国家预防艾滋病母婴传播经济学评价的文献，分析各国的成本-效果、成本-效用和成本-效益，对其数据进行提取、整合。结果13篇文献关注的是成本-效果，3篇文献研究的是成本-效用，9篇文献既研究了成本-效果又研究了成本-效用。结论在低、中等收入国家，预防艾滋病病毒母婴传播成本-效果最好的干预措施是孕妇自愿咨询检测（VCT）和短期口服抗逆转录病毒治疗方案（HIVNET012）／齐多夫定与抗逆转录病毒药物合用的治疗方案（ACTG076）的同时使用。成本-效用最好的干预措施是孕期抗逆转录病毒（ACTG076）和28 w＋ HIVNET012＋ HIV 阳性儿童的抗逆转录病毒治疗。成本-效果和成本-效用能够同时实现的干预措施是药物的使用，且最好在产后1 w 使用。