Table 1.
Model inputs
| Variable | Base Case | Reference |
|---|---|---|
| Cohort characteristics at time of HIV infection | ||
| CD4 cell count, mean cells/μl (SD) | 751 (267) | [45] |
| Age, years | 35 | [19] |
| HIV RNA distribution post-acute infection (%) | [46] | |
| >100,000 copies/ml | 25 | |
| 30,001–100,000 copies/ml | 42 | |
| 10,001–30,000 copies/ml | 21 | |
| <10,000 copies/ml | 12 | |
| Baseline ART adherence, % | derived from [47, 48] | |
| Adherence < 50% | 3.1 | |
| 50% ≤ Adherence < 95% | 50.7 | |
| Adherence ≥ 95% | 46.2 | |
| First-line ART efficacy | ||
| HIV RNA suppressed at 6 months, % | 83.5 | [49] |
| Loss to follow-up and return to care, per 100 person years* | ||
| Loss to follow-up rate on ART | 7.5 | HIVRN data |
| Return to care rate | 16.9 | HIVRN data |
| Treatment initiation | ||
| CD4 count at ART initiation (mean cells/μl) | 342† | [30, 31] |
| Unit Costs | ||
| % discount from AWP applied to non-generic drugs | 23 | [50] |
| Inpatient visit (2012 US dollars) | 2,228 | See Appendix |
| Outpatient visit (2012 US dollars) | 123 | See Appendix |
| Emergency department visit (2012 US dollars) | 723 | See Appendix |
| CD4 test (2012 US dollars) | 72 | [51] |
| HIV RNA test (2012 US dollars) | 131 | [51] |
| Estimated mean annual costs (SE, 2012 US dollars)‡ | ||
| Age and disease stage | ||
| 18–29 years | ||
| HIV-uninfected individuals | 1,468 (168) | MEPS§ |
| HIV-infected individuals (CD4 cells) | HIVRN | |
| <= 50/μl | 35,272 (2,426) | |
| 51–200/μl | 26,934 (1,420) | |
| 201–350/μl | 22,891 (1,131) | |
| 351–500/μl | 20,881 (1,013) | |
| >500/μl | 19,682 (940) | |
| 30–39 years | ||
| HIV-uninfected individuals | 1,998 (381) | MEPS§ |
| HIV-infected individuals (CD4 cells) | HIVRN | |
| <= 50/μl | 40,633 (2,416) | |
| 51–200/μl | 31,028 (1,214) | |
| 201–350/μl | 26,371 (920) | |
| 351–500/μl | 24,055 (815) | |
| >500/μl | 22,674 (736) | |
| 40–49 years | ||
| HIV-uninfected individuals | 3,347 (488) | MEPS§ |
| HIV-infected individuals (CD4 cells) | HIVRN | |
| <= 50/μl | 44,745 (2,490) | |
| 51–200/μl | 34,167 (1,118) | |
| 201–350/μl | 29,039 (759) | |
| 351–500/μl | 26,489 (660) | |
| >500/μl | 24,968 (565) | |
| 50+ years | ||
| HIV-uninfected individuals | 6,622 (499) | MEPS§ |
| HIV-infected individuals (CD4 cells) | HIVRN | |
| <= 50/μl | 48,217 (2,863) | |
| 51–200/μl | 36,818 (1,327) | |
| 201–350/μl | 31,292 (880) | |
| 351–500/μl | 28,545 (790) | |
| >500/μl | 26,905 (675) | |
*
Loss to follow-up is defined as an interruption in care of at least 12 months
†
Range 261–480 depending on sex, race/ethnicity, and transmission category (see Appendix Table 1)
‡
Estimated mean monthly costs summarized in this table are weighted by transmission risk group (see Appendix Table 2)
§
Medical Expenditure Panel Survey (MEPS) data are assigned to transmission risk groups based on sex and race/ethnicity for each risk group at each age
SD: standard deviation; ART: antiretroviral therapy; HIVRN: HIV Research Network; AWP: average wholesale price; MEPS: Medical Expenditure Panel Survey; SE: standard error