A Low-cost In-house HIV Integrase Strand-Transfer Inhibitor Drug Resistance Test for Resource-limited Settings

HIV drug resistance (HIVDR) testing (DRT) is costly in nature and this limits its access in resource-limited settings. A cost-effective in-house integrase strand transfer inhibitor (INSTI) assay has been developed and we estimate the cost of offering this HIVDR test from a provider’s perspective. Ethical approval for this study was obtained from the Kenyatta National Hospital - University of Nairobi Ethics and Research Committee (KNH-UoN ERC); approval number P263/05/2020. An incremental ingredient costing approach was used to estimate the cost of reagents and consumables required to perform the HIVDR INSTI assay. Data was collected through time and motion study to identify and quantify inputs to the assay. Prices were abstracted from laboratory records including quotations, delivery notes and invoices. Cost data entry was done in Excel software (Microsoft, New York, USA). We used an Excel based model to compute the integrase assay unit cost. All costs were converted to US dollars 2020 (13th September 1 US $= KES.108.54).