单阶段的全方位第一季度细胞巨乳病毒查和怀孕期间的瓦拉基克洛维尔预防:在高血清发病率环境中的成本效益分析
Zhi Zhen Lim1, Clarence Ong1, Ching Yee Chan2
1Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Prenatal diagnosis
|July 8, 2025
概括
使用瓦拉西克洛维尔进行的通用细胞巨乳病毒 (CMV) 查具有成本效益,可以预防先天性CMV (cCMV) 后续. 这一策略避免了儿童发病率,并与其他产前查相比较有利.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 卫生经济学 卫生经济学
背景情况:
- 先天性细胞巨乳病毒 (cCMV) 感染是导致儿童非遗传性神经感官听力损失和认知障碍的主要原因.
- 目前对CMV的查协议往往是反应性的或有针对性的,错过了早期干预的机会.
研究的目的:
- 进行一个成本效益分析,比较普遍的第一季度细胞巨乳病毒 (CMV) 血清查与瓦拉西克洛维尔预防与常规超声波导向测试.
- 为了确定通用CMV查的增量成本效益比率 (ICER).
主要方法:
- 用决策树和马尔科夫模型进行付款人视角的成本效益分析.
- 模拟了一群假设的10万名孕妇在怀孕期间和孩子的一生中.
- 通过预防cCMV后续而获得的评估质量调整寿命年 (QALYs).
主要成果:
- 普遍查的ICER为125,864美元/QALY,防止了每10万名母亲中大约54例cCMV感染.
- 这一策略在5岁时避免了18例症状感染和17例神经感官听力损失和认知障碍.
- 影响成本效益的关键因素包括瓦赛克洛维尔的疗效,CMV流行率和症状cCMV的概率.
结论:
- 随着瓦拉西克洛维尔预防的全方位CMV查是一种潜在的成本效益的策略,与其他产前查相比较.
- 这种方法可以显著减少与cCMV相关的儿童发病率.
- 瓦拉克洛维尔的有效性,CMV流行率和症状性cCMV风险是优化ICER的关键变量.
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