Table 1.
Base Case Input Parameters for an Analysis of Baseline Genotype at Human Immunodeficiency Virus Diagnosis Compared to No Baseline Genotype
| Parameter | Base Case Value | Range | Reference | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Cohort characteristics | |||||||||
| Age, mean (SD), y | 35 (13) | … | [24] | ||||||
| Sex, male/female, % | 81/19 | … | [24] | ||||||
| Initial CD4 cell count, mean cells/µL (SD) | 346 (175) | … | [25] | ||||||
| HIV RNA distribution, % | [26] | ||||||||
| >100 000 copies/mL | 25 | … | |||||||
| 30 001–100 000 copies/mL | 42 | … | |||||||
| 10 001–30 000 copies/mL | 21 | … | |||||||
| 3001–10 000 copies/mL | 6 | … | |||||||
| ≤3000 copies/mL | 6 | … | |||||||
| Transmitted drug resistance prevalence | [15] | ||||||||
| NRTI-R, % | 5.8 | 3–40 | |||||||
| NNRTI-R, % | 7.2 | 5–40 | |||||||
| PI-R, % | 3.2 | 0–40 | |||||||
| ART efficacya | |||||||||
| Suppression (HIV RNA <50 copies/mL at 12 mo), mean, % | |||||||||
| Parameter | No TDR | NRTI-R | NNRTI-R | PI-R | Reference | ||||
| No BG | BG | No BG | BG | No BG | BG | No BG | BG | ||
| DTG-based regimenb | 92 | 92 | 82 c | 92 | 92 | 92 | 92 | 92 | [27, 28] |
| RPV-based regimenb | 83 | 83 | 57 d | 83 | 40 e | … | 83 | 83 | [29, 30] |
| DRV/r-based regimenb | 83 | 83 | 83 | 83 | 83 | 83 | … | … | [31] |
| Parameter | Base Case Value | Range | Reference | ||||||
| Regimen switch | |||||||||
| Time to regimen switch after observed failure, mo | 3 | 3–12 | [1] | ||||||
| Severe DTG AE requiring regimen change, % | 14 | 5–50 | [32] | ||||||
| Time from DTG start to AE, mo | 4 | … | [32, 33] | ||||||
| Costs (2018 USD) | |||||||||
| Laboratory tests | [34] | ||||||||
| Standard genotype resistance test | 320 | 0–500 | |||||||
| Integrase strand inhibitor genotype resistance test | 160 | … | |||||||
| Monthly routine care costs | 300–1200 | … | [35] | ||||||
| Monthly ART regimenf | [36] | ||||||||
| DTG-based regimen | 3000 | … | |||||||
| RPV-based regimen | 2500 | 1000–3500 | |||||||
| DRV/r-based regimen | 3000 | … |
Bold numbers indicate differences between strategies.
Abbreviations: AE, adverse event; ART, antiretroviral therapy; BG, baseline genotype; DRV/r, ritonavir-boosted darunavir; DTG, dolutegravir; HIV, human immunodeficiency virus; NNRTI-R, nonnucleoside reverse transcriptase inhibitors resistance; NRTI-R, nucleoside reverse transcriptase inhibitors resistance; PI-R, protease inhibitors resistance; RPV, rilpivirine; SD, standard deviation; TDR, transmitted drug resistance.
aExamined ranges for ART efficacy are reported in footnotes c, d, and e due to space restrictions.
bDTG- and RPV-based regimen suppression is based on treatment-naive patient populations given that these regimens are prescribed early in ART treatment. DRV/r-based regimen suppression is based on treatment-experienced patient populations given that this regimen is prescribed later in the care cascade.
cDTG-based regimen suppression with transmitted NRTI-R: base case, 82%; range, 40%–93%.
dRPV-based regimen suppression with transmitted NRTI-R: base case, 57%; range, 20%–80%.
eRPV-based regimen suppression with transmitted NNRTI-R: base case, 40%; range, 20%–80%.
fART regimen costs are based on average wholesale price and discounted by 23% for branded drugs. ART regimens costs do not differ by choice of NRTI.