Evidence on the cost-effectiveness of lifelong antiretroviral therapy for prevention of mother-to-child transmission of HIV: implications for resource-limited countries in sub-Saharan Africa

Abstract

The 2016 World Health Organization (WHO) consolidated guideline recommends lifelong antiretroviral therapy (ART) for all HIV-infected pregnant and breastfeeding women for preventing mother-to-child HIV transmission (PMTCT). Ambiguity remains about the cost-effectiveness of this strategy in resource-limited developing countries. Areas covered: We reviewed model-based studies on the cost-effectiveness of lifelong ART (formerly Option B+) relative to previous WHO guidelines for PMTCT. Our search using PubMed, Medline and Google Scholar for articles on Option B+ resulted in the final inclusion of seven studies published between 2012 and 2016. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess the quality of reporting. Outcomes of interest, which included infant infections averted, maternal quality and length of life, and the Incremental Cost Effectiveness Ratio (ICER), were used in comparing cost-effectiveness. Expert commentary: Despite most model-based studies favouring lifelong ART (Option B+) in terms of its cost-effectiveness in comparison to Options A and B, inclusiveness of the evidence remains weak for generalization. This is largely because setting specificity for providing lifelong ART to all pregnant and breastfeeding women may differ significantly in each setting. Consequently, future cost-effectiveness studies should be robust, setting-specific, and endeavor to assess the willingness and ability to pay of each setting.

Reported needs of information resources, research tools, connectivity and infrastructure among African Pharmacological Scientists to improve future patient care and health

“…This leads, as mentioned, to a higher prevalence of NCDs including diabetes mellitus and hypertension, which together with concerns with adherence, are subjects being actively researched by MURIA members and others [10,[45][46][47][48][49][50][51][52][53][54]. As discussed, HIV/AIDS research is still a key area in SSA with 5.6% of respondents active in this area of research as seen by MURIA member activities in Namibia and South Africa [55][56][57][58]. This is explainable partly by the high prevalence rates of HIV in SSA and partly by reseachers interests occasioned by the priorities of the funders [3,11]].…”

Acceptability and Consumer Willingness to pay for a hypothetical HIV vaccine in Northern Brazil: A cross-sectional study and the implications

“…We believed a WTP would help understanding of the potential value of any hypothetical vaccine for HIV from the perspective of (Godói et al, 2017;Muniz Junior et al, 2018;Sarmento et al, 2019;Athie et al, 2021;Godói et al, 2021). (Bishai et al, 2004;Ngambi et., 2017;Usman & Usman, 2019).…”

Stevens Johnson Syndrome and Toxic Epidermal Necrolysis Induced by Nevirapine among HIV-Infected Pregnant Women: Five Cases

“…Antiretroviral therapy has greatly improved the mortality rate and risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection in resource-limited countries [1]. However, studies have reported the frequency of some risk factors in the occurrence of toxidermia in patients living with HIV.…”