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AIDS Weekly Plus
Researchers from Cornell University College of Medicine Report New Studies and Findings in the Area of HIV/AIDS
Staff Writer
September 2, 2013


2013 SEP 2 (NewsRx) -- By a News Reporter-Staff News Editor at AIDS Weekly -- New research on Immune System Diseases and Conditions is the subject of a report. According to news reporting out of New York City, New York, by NewsRx editors, research stated, "Homozygosity for UGT1A1*28/*28 has been reported to be associated with atazanavir-associated hyperbilirubinaemia and premature atazanavir discontinuation. We assessed the potential cost-effectiveness of UGT1A1 testing to inform the choice of an initial protease-inhibitor-containing regimen in antiretroviral therapy (ART)-naive individuals."

Our news journalists obtained a quote from the research from the Cornell University College of Medicine, "We used the Cost-Effectiveness of Preventing AIDS Complications computer simulation model to project quality-adjusted life years (QALYs) and lifetime costs (2009 USD) for atazanavir-based ART with or without UGT1A1 testing, using darunavir rather than atazanavir when indicated. We assumed the UGT1A1-associated atazanavir discontinuation rate reported in the Swiss HIV Cohort Study (a *28/*28 frequency of 14.9%), equal efficacy and cost of atazanavir and darunavir and a genetic assay cost of $107. These parameters, as well as the effect of hyperbilirubinaemia on quality of life and loss to follow up, were varied in sensitivity analyses. Costs and QALYs were discounted at 3% annually. Initiating atazanavir-based ART at CD4(+) T-cell counts <500 cells/?l without UGT1A1 testing had an average discounted life expectancy of 16.02 QALYs and $475,800 discounted lifetime cost. Testing for UGT1A1 increased QALYs by 0.49 per 10,000 patients tested and was not cost-effective (>$100,000/QALY). Testing for UGT1A1 was cost-effective (<$100,000/QALY) if assay cost decreased to $10, or if avoiding hyperbilirubinaemia by UGT1A1 testing reduced loss to follow-up by 5%. If atazanavir and darunavir differed in cost or efficacy, testing for UGT1A1 was not cost-effective under any scenario."

According to the news editors, the research concluded: "Testing for UGT1A1 may be cost-effective if assay cost is low and if testing improves retention in care, but only if the comparator ART regimens have the same drug cost and efficacy."

For more information on this research see: Cost-effectiveness analysis of UGT1A1 genetic testing to inform antiretroviral prescribing in HIV disease. Antiviral Therapy, 2013;18(3):399-408 (see also Immune System Diseases and Conditions).

Our news journalists report that additional information may be obtained by contacting B.R. Schackman, Dept. of Public Health, Weill Cornell Medical College, New York, NY, United States. Additional authors for this research include D.W. Haas, J.E. Becker, B.K. Berkowitz, P.E. Sax, E.S. Daar, H.J. Ribaudo and K.A Freedberg.

Keywords for this news article include: Antiinfectives, Antiretrovirals, Antivirals, Drugs, Therapy, Genetics, HIV/AIDS, Darunavir, RNA Viruses, Retroviridae, New York City, United States, HIV Infections, Vertebrate Viruses, Protease Inhibitors, Primate Lentiviruses, North and Central America, Viral Sexually Transmitted Diseases.

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