Table 1.
Input Parameters for a Modeling Analysis of Combination Human Immunodeficiency virus Treatment Strategies in Rural Kenya
| Parameter | Base-Case Value | Reference |
|---|---|---|
| Baseline cohort characteristics | ||
| Age, median (IQR), y | 30 (21–44) | [5] |
| Female/male sex, % | 52/48 | [5] |
| CD4 cell count at diagnosis, mean (SD), cells/µL | 560 (230) | [24] |
| Baseline cascade of care | ||
| Probability of HIV diagnosis if major event | 0.40 | Calibration to [5] |
| Probability of background testing, monthly | 0.008 | Calibration to [5] |
| Probability of linkage to care when tested | 0.65 | Calibration to [5] |
| Probability of retention in care when linked, monthly | 0.97 | Calibration to [5] |
| Probability of treatment, monthly | ||
| CD4 cell count >200/µL | 0.20 | Calibration to [5] |
| CD4 cell count ≤200/µL | 0.70 | Calibration to [5] |
| Viral suppression rate at 1 y (95% CI) | 0.80 (.77–.83) | [5] |
| Costs of current care (2014 €) | ||
| Outpatient, yearlya | 257 | Assumption |
| Consultation | 9 | MSF (unpublished) |
| ART regimen (tenofovir, lamivudine and efavirenz), monthly | 10 | MSF (unpublished) |
| HIV RNA testing | 49 | MSF (unpublished) |
| CD4 count testing | 21 | MSF (unpublished) |
| Inpatient, per stayb | 101 | |
| Hospitalization cost, daily | 24.25 | MSF (unpublished) |
| Admission fee | 4 | MSF (unpublished) |
| Planned interventions | ||
| Voluntary community testing | ||
| Effectiveness target by MSF | ||
| Sensitivity | 1.0 | Assumption |
| Specificity | 1.0 | Assumption |
| Testing coverage (in 2 y) | 0.9 | Assumption |
| Overall start-up cost (2014 €) | ||
| Laboratory | 4763 | MSF (unpublished) |
| Logistics | 31883 | MSF (unpublished) |
| Human resources | 38835 | MSF (unpublished) |
| Fixed cost (2014 €), monthly | ||
| Laboratory | NA | Assumption |
| Logistics | 3310 | MSF (unpublished) |
| Human resources | 4616 | MSF (unpublished) |
| Variable cost (2014 €) | ||
| Laboratory (per kit) | 10 | MSF (unpublished) |
| Logistics (gas, per liter) | 2 | MSF (unpublished) |
| Human resources | NA | Assumption |
| Linkage | ||
| Effectiveness target by MSF | Assumption | |
| Probability of linkage to care | 0.9 | Assumption |
| Start-up cost (2014 €) | ||
| Laboratory | 4763 | MSF (unpublished) |
| Logistics | 31883 | MSF (unpublished) |
| Human resources | 38835 | MSF (unpublished) |
| Fixed cost (2014 €) | ||
| Laboratory | NA | Assumption |
| Logistics | 3310 | MSF (unpublished) |
| Human resources | 9232 | MSF (unpublished) |
| Variable costs (2016 €) | NA | Assumption |
| Retention intervention | ||
| Targeted cascade | ||
| Suppression rate at 1 y | 0.9 | Assumption |
| Start-up cost (2014 €) | ||
| Laboratory | 119942 | MSF (unpublished) |
| Logistics | 1431 | MSF (unpublished) |
| Human resource | 419836 | MSF (unpublished) |
| Fixed cost (2014 €), monthly | ||
| Laboratory | 6644 | MSF (unpublished) |
| Logistics | 3030 | MSF (unpublished) |
| Human resources | 11061 | MSF (unpublished) |
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; HIV, human immunodeficiency virus; IQR, interquartile rangea; MSF, Médecins Sans Frontières; NA, not applicable; SD, standard deviation.
aCalculated based on 2 consultations per year with HIV RNA measurement, 1-time CD4 cell count, and 12 months of ART.
bCalculated based on a single upfront admission fee and multiplying the daily hospitalization cost by the average length of stay (4 days).