UCSF Study Finds Drug Treatment Can Be Cost Effective In Tanzania And Thailand For HIV-Positive Pregnant Women

July 03, 1998

Geneva, Switzerland -- Antiviral drug treatment can be a cost-effective measure in both Tanzania and Thailand to reduce the high rate of mother-to-child transmission of HIV, say University of California San Francisco AIDS researchers.

In a new study, the UCSF team found that short-course therapy using the antiviral drug zidovudine, or AZT, was economically feasible in both urban and rural populations in these countries.

Research findings were reported here today (July 3) at the 12th World AIDS Conference.

"In this study, we wanted to determine under what conditions, if any, this short-course drug regimen might be a good investment compared with funding for other types of HIV prevention efforts in very poor countries, such as Tanzania, and in those with more resources, such as Thailand," said Elliot Marseille, DrPH, MPP, lead investigator and senior research associate with the UCSF AIDS Research Institute and the UCSF Institute for Health Policy Studies.

The researchers chose AZT for their economic analysis because of previous clinical trials in Thailand that showed short-course treatment with this drug reduced transmission of HIV from pregnant women to their unborn children by 50 percent. The trials were sponsored by the Centers for Disease Control and Prevention.

"This is important because short-course therapy, which begins four weeks before the birth due date and ends after delivery, is far more affordable than the standard regimen in the industrialized world, which begins 12 weeks before the due date and also involves continued treatment of the infant in the post-natal period," Marseille said.

He added, "This means that prevention is now possible for a much higher portion of mother-to-child HIV transmission cases worldwide."

In the UCSF study, researchers used a mathematical model to calculate cost-effectiveness by comparing costs and outcomes of no drug treatment to short-course AZT therapy in pregnant women from three different settings. The settings were rural Tanzania with an HIV prevalence rate among pregnant women of 15 percent, an urban area of Thailand with a low rate of 1.8 percent, and an urban area of Thailand with a high rate of 5.2 percent. The study's key findings include: Study co-investigators are James G. Kahn, MD, MPH, UCSF associate professor of health policy and epidemiology, who presented the findings at the Geneva meeting; and Joseph Saba, MD, clinical research specialist, United Nations AIDS Program.

Last week, Glaxo Wellcome and other pharmaceutical manufacturers announced plans to reduce prices of AIDS drugs in low-income countries to about 25 percent of industrial world prices, according to Marseille.

"This action opens the way for large-scale drug interventions because we now know that these therapies can make both medical and economic sense," he said. In previous studies in the U.S., the AIDS Clinical Trial Group of the National Institutes of Health found treatment with AZT beginning at the 28th week of pregnancy reduced mother-to-child HIV transmission by about 66 percent.

"While this protocol has great implications for efforts to stem transmission, it is not practical in most developing countries where women normally do not seek prenatal care this early in the pregnancy and a long course of therapy is too costly given their limited resources," Marseille said.

According to co-investigator Kahn, the UCSF analysis "demonstrates that the interventions initially tested in the U.S. and other wealthy countries can lead to affordable public health strategies in poorer countries." But several steps must occur, he noted, for this to happen: shorter therapy and other changes to minimize resource use, careful evaluation of treatment efficacy of modified therapies, and reduction of high cost components, such as drug prices.

University of California - San Francisco

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.