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

Published online by Cambridge University Press:  02 January 2015

Simone Mathoulin-Pelissier ,
Louis-Rachid Salmi ,
Pierre Fialon  and
Roger Salamon
Simone Mathoulin-Pelissier*
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
Louis-Rachid Salmi
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
Pierre Fialon
Affiliation:
Bordeaux University Hospital, Bordeaux, France
Roger Salamon
Affiliation:
Institute of Public Health, Epidemiology, and Development, Bordeaux University Hospital, Bordeaux, France
*
Institut Bergonié, 229 Cours de l'Argonne, 33076 Bordeaux cedex, France
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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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 2 , February 2003 , pp. 132 - 136
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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