[Cost-benefit analysis of screening strategies by human immunodeficiency virus in French blood donors].
BACKGROUND
The residual risk of human immunodeficiency virus (HIV) infection from screened blood transfusion was estimated to be 1.7/10(6) between 1993 and 1995 in France. To orient blood safety policies, we have evaluated what would be, from the perspective of blood banks, the best screening strategy in terms of gain in effectiveness and added costs.


METHODS
A cost-effectiveness analysis compared 20 HIV-testing protocols using (1) available data for performances of the current screening tests; and, (2) national insurance estimates for the cost of tests. Results were expressed as the number of false negative donations that would be avoided and the cost by avoided false negative donation.


RESULTS
For 3 million donated blood units a year and a prevalence of 24 per million, there would be 72 infectious donated blood units, 70.56 of which would be detected by the current screening strategy. The number of additional donated blood infections avoided in all other strategies would be low (between 0.25 and 1.28) with a very high cost (280 million French francs per added false negative avoided or more).


CONCLUSIONS
A change in screening strategies for blood donations in France is not currently justified. If such a change was to be done, adding p24 antigen detection to the current screening strategy would be one of the worst solutions.
Djossou
F
F
Institut de santé publique, d'épidémiologie et de développement, université Victor Segalen Bordeaux 2, France.
Salmi
L R
LR
Lawson-Ayayi
S
S
Huët
C
C
Perez
P
P
Mathoulin-Pélissier
S
S
Salamon
R
R
D015492:AIDS Serodiagnosis / Q000191:economics* / Q000379:methods; D001771:Blood Banks / Q000191:economics*; D001782:Blood Donors; D001803:Blood Transfusion; D003362:Cost-Benefit Analysis; D005188:False Negative Reactions; D005602:France; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000517:prevention & control*; D015528:HIV Seroprevalence; D006801:Humans; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D012449:Safety; D000094902:Blood Banking / Q000379:methods
D016655:HIV Core Protein p24
Analyse coût-efficacité des stratégies de dépistage de l'infection par le virus de l'immunodéficience humaine sur les dons de sang en France.