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Cost-Effectiveness of Testing for Human Immunodeficiency Virus And Hepatitis C Virus Among Blood Transfusion Recipients

  • Simone Mathoulin-Pelissier (a1), Louis-Rachid Salmi (a1), Pierre Fialon (a2) and Roger Salamon (a1)

Abstract

Objective:

To choose the most cost-effective option for detecting human immunodeficiency virus (HIV-1) and hepatitis C virus (HCV) among blood transfusion recipients.

Design:

Cost-effectiveness analysis. Effectiveness was expressed as the number of HIV-1 or HCV infections detected, regardless of whether they were related to transfusion. To estimate costs, we assumed hospital insurance would cover costs related to detection and compensation, when granted.

Setting:

A 2,890-bed acute care teaching hospital in Bordeaux, France.

Methods:

Eight options were defined, from the simplest, which would be to do nothing, to a maximal approach, which would be to keep a serum sample in a serum library for a lookback and perform tests for antibody to HIV-1 and to HCV before and 3 months after transfusion. Data on probabilities and costs were taken from the literature and experiences of French hospitals.

Results:

The most cost-effective option was to perform viral antibody testing before transfusions (option 3), which would detect 27 infections per 1,000 patients, for an expenditure of US $1,260 per detected patient Option 6, obtaining a serum sample before transfusion and performing tests for antibody to HIV-1 and to HCV 3 months after transfusion, had a similar cost-effectiveness ratio but detected only 16 infections per 1,000 patients. Performing tests before and 3 months after transfusion (option 4), compared with option 3, would detect 1 additional infection for an additional cost of US $8,322.

Conclusion:

The most cost-effective options are not specific to blood transfusion recipients and might be more suited to all hospitalized patients.

Copyright

Corresponding author

Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux cedex, France

References

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