Table 2.
Clinical characteristics of newly detected HIV-infected individuals eligible for care through discretionary and entitlement programsa
| Current Practice | Expanded Screening | |
|---|---|---|
| Number identified over 5-year period | ||
| Prevalent cases in year 1 (N) | 54,343 | 63,747 |
| Prevalent cases in year 2 (N) | 18,362 | 24,062 |
| Prevalent cases in year 3 (N) | 17,276 | 19,755 |
| Prevalent cases in year 4 (N) | 14,759 | 15,106 |
| Prevalent cases in year 5 (N) | 11,366 | 10,651 |
| Total prevalent cases in period (N) | 116,107 | 133,321 |
| Incident cases in year 1 (N) | 4,099 | 6,701 |
| Incident cases in year 2 (N) | 8,379 | 13,258 |
| Incident cases in year 3 (N) | 12,340 | 18,764 |
| Incident cases in year 4 (N) | 16,086 | 23,417 |
| Incident cases in year 5 (N) | 19,618 | 27,361 |
| Total incident cases in period (N) | 60,523 | 89,501 |
|
| ||
| Mechanism of detection, prevalent cases | ||
| Screening (%) | 19.7 | 33.1 |
| Opportunistic infection (%) | 68.3 | 57.8 |
| Never detected (%) | 12.0 | 9.1 |
|
| ||
| Mechanism of detection, incident cases | ||
| Screening (%) | 39.3 | 60.2 |
| Opportunistic infection (%) | 49.0 | 32.3 |
| Never detected (%) | 11.7 | 7.5 |
|
| ||
| CD4 count at detection | ||
| Prevalent (mean cells/mm3) | 122 | 140 |
| Incident (mean cells/mm3) | 251 | 312 |
|
| ||
| Incremental quality-adjusted survival per personb | ||
| Prevalent cases (ΔQALYs) | -- | 2.0 |
| Incident cases (ΔQALYs) | -- | 3.2 |
Clinical characteristics are different from Table 1 input parameters. Table 1 input parameters refer to the actual but unobserved characteristics at the start of the simulation. Table 2 input parameters refer to observed clinical characteristics upon detection. CD4 counts are lower in Table 2 because it takes time for HIV-infected cases to become detected, during which time CD4 counts generally fall. “Prevalent aware” cases are not included in this table because they have already been detected.
These numbers refer to the quality-adjusted survival over the newly detected cases’ lifetime, and not just the five-year time horizon of the budget impact analysis.