初级HPV查与其他宫癌查策略相比,在艾滋病毒感染妇女:一个成本效益研究
Ran Zhao1, Erinn Sanstead1, Fernando Alarid-Escudero2
1University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN.
AIDS (London, England)
|September 4, 2024
概括
目前对艾滋病毒感染妇女的宫癌查是具有成本效益的. 初级HPV查显示,它是一个具有成本效益的替代品,但需要更高的测试接受度和精细的后续策略.
科学领域:
- 妇科 妇科 妇科 妇科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 人类乳头瘤病毒 (HPV) 是导致子宫癌的主要原因.
- 携带艾滋病毒 (WWH) 的妇女患子宫癌的风险增加.
- 目前对WWH的查指南各不相同,需要进行评估.
研究的目的:
- 为了比较不同宫癌查策略的成本效益,美国妇女生活在艾滋病毒.
- 评估细胞学,联合测试和初级HPV查的益处和危害.
- 为WWH提供最佳查建议.
主要方法:
- 一个马尔科夫决策模型被调整为模拟与艾滋病毒感染的美国女性队列.
- 在30岁及以上的女性中模拟了五种查策略.
- 结局包括结肠镜检查,错误阳性,治疗,癌症,死亡,寿命和质量调整寿命.
主要成果:
- 与没有查相比,查节约了成本,并预防了超过96%的宫癌和死亡.
- 细胞学与HPV选占主导地位,主要的HPV查和配合测试.
- 初级HPV测试比在25万美元以下的支付意愿门上进行联合测试更具成本效益.
结论:
- 目前基于细胞学的查对WWH来说是具有成本效益的.
- 初级HPV查提供了一个潜在的成本效益高的替代方案.
- 提高成本效益需要提高HPV测试的接受率和优化后续协议,以减轻错误阳性.
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