Table 1.
Selected input parameters for a model-based analysis of POC EID vs. conventional EID in Zimbabwe.
| Cohort characteristics | Value | Sources* |
|---|---|---|
| Age, months (SD) | 0 (0) | Assumption |
| Female/Male (%) | 51·2/48·8 | 10 |
| Mothers with maternal CD4 ≤ 350 cells/μL before ART (%) | 36 | 10 |
| Mothers receiving ART during pregnancy and breastfeeding (%) | 93 | 2 |
| Breastfeeding, proportion of all mother-infant pairs (%) | 80 | Assumption |
| Mean breastfeeding duration, months (SD) | 18 (2) | 14 |
| EID cascade parameters | Value | Sources* |
| EID uptake (%) | 100 | Modelled population |
| Probability of receiving test results (%) | ||
| Conventional EID | 80·0 | 5 |
| POC EID | 99·0 | |
| Delay between primary test and result receipt, months (SD) | ||
| Conventional EID | 2 (0) | 5 |
| POC EID | 0 (0) | |
| Delay between confirmatory test and result receipt, months (SD) | ||
| Conventional EID | 0 (1) | 5 |
| POC EID | 0 (0) | |
| Probability of linking to care/ART among those tested (%) | ||
| Conventional EID | 51·9 | 5 |
| POC EID | 98·5 | |
| Nucleic Acid Test (Conventional) assay characteristics | Value (%) | Sources* |
| Sensitivity for IU infection (all ages) | 100 | |
| Sensitivity for IP infection (month 1, later months) | 0, 100 | 17 |
| Sensitivity for PP infection (month of infection, later months) | 0, 100 | |
| Specificity (all ages) | 99·6 | |
| Error rate** | 1·4 | 32 |
| Point-of-Care (POC) assay characteristics | Value (%) | Sources* |
| Sensitivity for IU infection (all ages) | 96·9 | |
| Sensitivity for IP infection (month 1, later months) | 0, 96·9 | |
| Sensitivity for PP infection (month of infection, later months) | 0, 96·9 | 15 |
| Specificity (all ages) | 100 | |
| Error rate** | 6·0 | |
| Costs | Value (2016 USD) | Sources* |
| HIV care, per month; (range by age, CD4) | $32·75-33·69 | 18 |
| CD4 test | $4·79 | 19 |
| VL test | $17·50 | 16 |
| ART regimen costs, per month (range by regimen, dose, age/weight) | $8·50-44 | 20 |
| Cost of conventional assay | $24·18 (1·4% error rate*) | 16, 32 |
| Cost of POC assay | $27·61 (6·0% error rate*) | 15, 16 |
Abbreviations: POC: point-of-care; EID: early infant HIV diagnosis; SD: standard deviation; ART: antiretroviral therapy; IU: intrauterine; IP: intrapartum; PP: postpartum; HIV: human immunodeficiency virus; RNA: ribonucleic acid; LPV/r: lopinavir/ritonavir; ABC: abacavir; 3TC: lamivudine; EFV: efavirenz; AZT: zidovudine; USD: United States dollar; VL: viral load.
Due to limited number of references permitted, here we cite previous CEPAC papers that used the same primary data sources; full primary data sources are listed in the Appendix, p. 13.
Error in performing a POC test (due to a platform malfunction, human error, etc.) leads to an inconclusive test result and a repeat test, but does not affect result-return.