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To the Editor.— The Thai Ministry of Health and the US Centers for Disease Control and Prevention recently released preliminary results from their trial demonstrating a 51% reduction of mother-to-child transmission associated with short-course zidovudine given from 36 weeks' gestation through labor.¹ Using this zidovudine efficacy estimate adjusted for a breast-feeding population, updated information on a range of counseling and testing costs,^2-3 prenatal maternal testing rates (Bernard Nahlen, MD, oral communication, April 1998), and reductions in zidovudine cost (announced by Glaxo Wellcome, Inc⁴), we reevaluated our analysis³ of the cost-effectiveness of short-course zidovudine for prevention of mother-to-child human immunodeficiency virus (HIV) transmission for sub-Saharan African countries with the greatest burden of HIV in childbearing women and infants (eg, Ivory Coast, Tanzania, Uganda).

Using previously published methods³ and these new data, the model estimates that a national short-course zidovudine program in a setting with 12.5% HIV seroprevalence in childbearing women . . . [Full Text of this Article]