Year 2019 / Volume 111 / Number 1
Original
The efficiency of several one-step testing strategies for the diagnosis of hepatitis C

10-16

DOI: 10.17235/reed.2018.5810/2018

Javier Crespo, José María Eiros Bouza, Antonio Javier Blasco Bravo, Pablo Lázaro de Mercado, Antonio Aguilera Guirao, Federico García, Javier García-Samaniego Rey, José Luis Calleja Panero,

Abstract
Background: implementing one-step strategies for hepatitis C diagnosis would help shorten the time to treatment access. Thus avoiding disease progression and complications, while facilitating hepatitis C virus (HCV) elimination. Objective: to assess the validity and certainty of potential one-step strategies for the diagnosis of HCV infection and their associated cost and efficiency. Methods: the study design is an economic appraisal of efficiency (cost/efficacy) using decision trees and deterministic sensitivity analysis. The analysis was performed from the payer perspective (Spanish National Health System), which exclusively considers the direct costs. Only the differential costs (diagnostic testing costs) were taken into account and the study was set in Spain. The efficacy of a diagnostic strategy was defined as the percentage of patients with an active HCV infection who received a positive diagnosis and the efficiency was defined as the cost per patient with a correctly diagnosed and active infection. Results: the one-step strategies evaluated for the diagnosis of HCV had an acceptable validity and certainty due to the high sensitivity and specificity of the considered tests. The Ab-Ag strategy was the most efficient, followed by Ab-Ag-VL and Ab-VL. Ab-Ag was the most efficient due to the lower cost per patient tested, although the efficacy was lower than the Ab-VL efficacy. Conclusion: the study findings may help to establish more appropriate one-step diagnostic approaches whilst considering the efficacy and efficiency.
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References
1. Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2:161-76.
2. WHO guidelines on hepatitis B and C testing. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO [Internet]. [consultado 2018 Ene 28]. Disponible en: https://www.finddx.org/wp-content/uploads/2017/02/WHO-guidelines-HBV-HCV-testing-Feb2017.pdf.
3. Lavin AC, Perello C, Llerena S, et al. Prevalence of hepatitis C in the Spanish population. The prevhep study (ETHON cohort). J Hepatology 2017;66:S272.
4. Rodríguez-Tajesa S, Dacalb Y, Collazos C, et al. Estudio de prevalencia de infección por los virus de la hepatitis B y C en Cataluña. 42 Congreso de la Asociación Española de Estudio del Hígado. Madrid, 15-17 de febrero de 2017.
5. Aguinaga A, Díaz-González J, Pérez-García A, et al. The prevalence of diagnosed and undiagnosed hepatitis C virus infection in Navarra, Spain, 2014-2016. Enferm Infecc Microbiol Clin. 2017 Jan 19. pii: S0213-005X(16)30401-3. doi: 10.1016/j.eimc.2016.12.008. [Epub ahead of print] Spanish.
6. Li G, De Clercq E. Current therapy for chronic hepatitis C: The role of direct-acting antivirals. Antiviral Res. 2017;142:83-122.
7. European Association for the Study of the Liver. EASL Recommendations on Treatment of Hepatitis C 2016. J Hepatol. 2017;66:153-94.
8. AASLD/IDSA HCV Guidance Panel. Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. Hepatology. 2015 Sep;62(3):932-54.
9. World Health Organisation, 2017a. Hepatitis C fact sheet [Internet]. [consultado 2018 Ene 29]. Disponible en: http://www.who.int/mediacentre/factsheets/fs164/en/
10. Global Hepatitis Report 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO [Internet]. [consultado 2018 Ene 29]. Disponible en: http://apps.who.int/iris/bitstream/10665/255016/1/9789241565455-eng.pdf
11. Buti M, Calleja JL, García-Samaniego J, et al. Eliminación de la Hepatitis C en España: Adaptación de un modelo matemático de salud pública partiendo del plan estratégico para el abordaje de la hepatitis C en el Sistema Nacional de Salud. Med Clin (Barc). 2017;148:277-82.
12. The Lancet. Eliminating viral hepatitis: time to match visions with action. Lancet. 2017;390:2121.
13. National Academies of Sciences, Engineering, and Medicine. 2017. A national strategy for the elimination of hepatitis B and C: Phase two report. Washington, DC: The National Academies Press.
14. Ministerio de Sanidad, Servicios Sociales e Igualdad. Plan estratégico para el abordaje de la hepatitis C en el sistema nacional de salud. Madrid, 21 de mayo de 2015.
15. Hsieh YH, Rothman RE, Laeyendecker OB, et al. Evaluation of the Centers for Disease Control and Prevention Recommendations for Hepatitis C Virus Testing in an Urban Emergency Department. Clin Infect Dis. 2016;62:1059-65.
16. Denniston MM, Jiles RB, Drobeniuc J, et al. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. 2014;160:293-300.
17. Grebely J, Lamoury FMJ, Hajarizadeh B, et al. Evaluation of the Xpert HCV Viral Load point-of-care assay from venepuncture-collected and finger-stick capillary whole-blood samples: a cohort study. Lancet Gastroenterol Hepatol. 2017;2:514-20.
18. Peeling RW, Boeras DI, Marinucci F, et al. The future of viral hepatitis testing: innovations in testing technologies and approaches. BMC Infect Dis. 2017 Nov 1;17(Suppl 1):699.
19. Grebely J, Applegate TL, Cunningham P, et al. Hepatitis C point-of-care diagnostics: in search of a single visit diagnosis. Expert Rev Mol Diagn. 2017;17:1109-15.
20. Assoumou SA, Tasillo A, Leff JA, et al. Cost-Effectiveness of One-Time Hepatitis C Screening Strategies Among Adolescents and Young Adults in Primary Care Settings. Clin Infect Dis. 2018;66:376-84.
21. Chhatwal J. Hepatitis C Screening: From Modeling to Public Health Policy. Clin Infect Dis. 2018;66:385-6.
22. Crespo J, Lázaro P, Blasco AJ, et al. El diagnóstico de la infección por el virus de la hepatitis C en España: una oportunidad para mejorar. Enferm Infecc Microbiol Clin. En prensa.
23. Wasitthankasem R, Vichaiwattana P, Auphimai C, et al. HCV core antigen is an alternative marker to HCV RNA for evaluating active HCV infection: implications for improved diagnostic option in an era of affordable DAAs. PeerJ. 2017;6:e4008. doi: 10.7717/peerj.4008. eCollection 2017.
24. Harris M, Ward E, Gore C. Finding the undiagnosed: a qualitative exploration of hepatitis C diagnosis delay in the United Kingdom. J Viral Hepat. 2016;23:479-86.
25. Yau AH, Lee T, Ramji A, et al. Rate, delay and predictors of hepatitis C treatment in British Columbia. Can J Gastroenterol Hepatol. 2015;29:315-20.
26. Levi M, Falla A, Taddei C, et al. Referral of newly diagnosed chronic hepatitis B and C patients in six EU countries: results of the HEPscreen Project. Eur J Public Health. 2016;26:561-9.
27. Casas MDLP, García F, Costa JJ, et al. Diagnóstico del virus de la hepatitis c: impacto de la actitud del servicio de Microbiología en la cascada del tratamiento. Enferm Infecc Microbiol Clin. 2017;35(Espec Cong 1):237.
28. Greenaway C, Azoulay L, Allard R, et al. A population-based study of chronic hepatitis C in immigrants and non-immigrants in Quebec, Canada. BMC Infect Dis. 2017;17:140.
29. Grassi A, Ballardini G. Hepatitis C in injection drug users: It is time to treat. World J Gastroenterol. 2017;23:3569-71.
30. Souliotis K, Agapidaki E, Papageorgiou M, et al. Access to treatment for Hepatitis C among injection drug users: results from the cross-sectional HOPE IV study. Int J Equity Health. 2017;16:101.
31. Blackburn NA, Patel RC, Zibbell JE. Improving Screening Methods for Hepatitis C Among People Who Inject Drugs: Findings from the HepTLC Initiative, 2012-2014. Public Health Rep. 2016;131 Suppl 2:91-7.
32. Casas P, Navarro D, Aguilera A, et al. A pilot study on the implementation of reflex testing for the diagnosis of active hepatitis C virus infection. Enferm Infecc Microbiol Clin. 2018 Jun 12. pii: S0213-005X(18)30192-7. doi:10.1016/j.eimc.2018.05.005. [Epub ahead of print] English, Spanish. PubMed PMID:29907367.
33. Buti M, Crespo J, García F, coordinadores. Diagnóstico de la hepatitis C en un solo paso. [Internet]. [Consultado 2018 junio 12]. Disponible en: http://aeeh.es/wp-content/uploads/2016/01/DX1P-AEEH-AEHVE-SEIMC-SEPD-definitivo.pdf
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Crespo J, Eiros Bouza J, Blasco Bravo A, Lázaro de Mercado P, Aguilera Guirao A, García F, et all. The efficiency of several one-step testing strategies for the diagnosis of hepatitis C. 5810/2018


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Publication history

Received: 05/07/2018

Accepted: 14/10/2018

Online First: 18/12/2018

Published: 17/01/2019

Article revision time: 84 days

Article Online First time: 166 days

Article editing time: 196 days


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