Cost-effectiveness of a post-exposure HIV chemoprophylaxis program for blood exposures in health care workers

We performed a cost-effectiveness analysis of a post-exposure chemoprophyla xis program for health care workers who sustained exposures to blood. We an alyzed a program of (1) treatment with zidovudine alone versus no treatment and (2) treatment with three-drug therapy versus no treatment. Assuming th at 35% of exposures were to HIV positive sources, the zidovudine regimen pr evented 53 HIV seroconversions per 100,000 exposures, at a societal cost of $2.0 million per case of HIV prevented, The cast per quality-adjusted life year saved was $175, 222. A three-drug chemoprophylactic therapy program ( postulating 100% effectiveness and 35% source HIV positivity), prevented 66 seroconversions per 100, 000 exposures, at a cost of $2.1 million per case of HIV prevented and $190,392 per quality-adjusted life year saved, Treati ng sources known to be HIV-positive and treating severe exposures were the most cost-effective strategies.