学术报告

报告题目: Cost-effectiveness of oral HIV pre-exposure prophylaxis and expanded antiretroviral therapy in the presence of drug resistance

报 告 人：沈明望 副教授/博导（西安交通大学公共卫生学院）

报告时间：2022年11月12日（星期六）上午10：00-11：00

报告地点：腾讯会议（217-156-932）

参加人员：教师、研究生、本科生

报告摘要：

Background： Oral pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) can effectively prevent HIV infections among men who have sex with men (MSM), but the emergence and transmission of HIV drug-resistance (HIVDR) may compromise their benefits. The costs and benefits of expanding PrEP and ART coverage in the presence of HIVDR in China remain unknown.

Methods: We developed a comprehensive dynamic transmission model incorporating the transmitted (TDR) and acquired (ADR) HIV drug resistance. The model was calibrated by the HIV surveillance data from 2009 to 2019 among MSM in Jiangsu Province, China, and validated by the dynamic prevalence of ADR and TDR. We aimed to investigate the impact of eight intervention scenarios (no PrEP, 20%, 50% or 80% of PrEP, without (77% coverage) or with (90% coverage) expanded ART) on the HIV epidemic trend and cost-effectiveness of PrEP over the next 30 years.

Findings: 20% or 50% PrEP + 90% ART would be cost-effective, with an incremental cost-effectiveness ratio (ICER) of 25,417 (95% confidence interval [CI]: 12,390−38,445) or 47,243 (23,756−70,729), and would yield 154,949 (89,662−220,237) or 179,456 (102,570−256,342) incremental quality-adjusted life-years (QALYs) over the next 30 years. No PrEP + 90% ART would yield 125,211 (73,448−176,974) incremental QALYs and be cost-saving. However, 20−80% PrEP + 77% ART and 80% PrEP + 90% ART with ICER of 77,862−98,338 and 63,332, respectively, and were not costeffective. A reduction of 64% in the annual cost of oral PrEP would make it highly cost-effective for 50% PrEP + 90% ART.

Interpretation: 20% or 50% PrEP + 90% ART is cost-effective for HIV control in the presence of HIVDR. Expanded ART alone may be the optimal policy under the current limited budgets.

报告人简介： 沈明望，现任西安交通大学公共卫生学院流行病与卫生统计学系副教授/博士生导师。2017年12月在西安交通大学数学与统计学院获得应用数学博士学位。2015年至2017年在美国德克萨斯大学奥斯汀分校生物统计系公派交流学习两年，曾获西安交通大学第三届“徐宗本应用数学论文奖”(一等奖)、第七届“十大学术新人”奖，并入选陕西省高校科协青年人才托举计划。主要研究方向为传染病动力学建模、生物数学、理论流行病学、人工智能在医学中的应用、卫生经济学评价等交叉学科研究。近5年主持项目8项，包括国家自然科学基金面上项目和青年基金项目、中国博士后科学基金面上项目（一等资助）和新冠肺炎疫情防控专项特别资助等。已发表SCI论文53篇，其中第一作者/通讯作者26篇，包括BMC Medicine、Lancet Regional Health-Western Pacific、Proceedings of the Royal Society B: Biological Sciences、Vaccine等。