Table 2.

Benefits and Costs of Acute HIV Testing and Treatment Strategies Over 20 Years – Base Case

			HIV Ab	HIV VL					ICER relative to§
Strategy*	New HIV Infections ¶	HIV Infections Prevented †	Tests Admini- stered (millions)	Tests Admin- istered (millions)	Total Costs (billions) ¥	Total QALYs (millions) ¥	Incremental Costs‡ (billions)	Incremental QALYs‡	Status Quo	Next Best Strategy
90% Annually, Ab+VL + Symptom-based	499,376	38,995 (7.2%)	118.28	120.19	$1,283	176.39	$13.65	389,711	$35,032	$105,398
90% Annually, Ab + Symptom-based	507,591	30,780 (5.7%)	118.31	38.88	$1,276	176.32	$6.43	321,164	$20,013	$29,923
67% Annually, Ab+VL + Symptom-based	510,651	27,720 (5.1%)	95.43	96.85	$1,280	176.27	$10.23	263,663	$38,783	Dominated
67% Annually, Ab + Symptom-based	515,925	22,446 (4.2%)	95.44	38.85	$1,275	176.22	$4.97	218,085	$22,786	Dominated
90% Annually, Ab	523,448	14,923 (2.8%)	87.68	-	$1,272	176.19	$2.31	183,535	$12,582	$12,582
Status Quo (67% Annually, Ab)	538,371		65.46	-	$1,270	176.00

^*Ab = antibody testing, VL = viral load testing.

^¶New HIV infections and HIV infections prevented are undiscounted totals. Discounting infections at 3% annually reduces the number of infections averted for each strategy by approximately 25%.

^†The values in parentheses are the fraction of total HIV infections prevented.

^¥Costs and quality-adjusted life years (QALYs) are net present values (3% discount rate) over 20 years.

^‡Incremental costs and QALYs are relative to the status quo.

^§ICER = Incremental cost-effectiveness ratio, relative to the status quo or the next-best strategy. Strategies that are dominated yield fewer QALYs at higher cost than the comparator.