Year 2022 / Volume 114 / Number 12
Original
Hepatitis C virus infection screening reduces mortality and is cost-effective independently of the intervention test

731-737

DOI: 10.17235/reed.2022.8609/2022

David Nicolás Pérez, Dalia Elena Morales Arráez, Iván Castilla Rodríguez, Fernando Gutiérrez Nicolás, Felicitas Díaz-Flores Estévez, Antonia de Vera González, Gloria Julia Nazco Casariego, Manuel Hernández Guerra,

Abstract
Introduction: Chronic infection due to hepatitis C virus (HCV) is frequently asymptomatic even in advanced stages of liver disease. Implementation of a screening program based on different HCV tests may enable an earlier diagnosis of HCV liver disease and subsequent application of highly effective treatment. Patients & methods: A Markov model which compares three different screening strategies for hepatitis C versus no screening in low-risk prevalence (general population) and high-risk prevalence population (people who inject drugs or prison population) was designed, taking into account age at the start of screening and participation. The three strategies were: 1) serological detection of antibodies against the HCV, 2) dried blood spot test (DBS) to detect antibodies against HCV and 3) detection of RNA from HCV. Quality-adjusted life-years (QALY) were taken as a measurement of effectiveness. The incremental cost-effectiveness ratio (ICER) was calculated and a deterministic and probabilistic sensitivity analysis was performed. Results: All three screening strategies were found to be cost-effective with an ICER of €13,633, €12,015 and €12,328/QALY for AntiHCV, DBS-AntiHCV and DBS-RNA HCV, respectively. There was a decrease in mortality due to liver disease in comparison to no screening for AntiHCV (40.7% and 52%), DBS-AntiHCV (45% and 80%) and DBS-RNA HCV (45.2% and 80%) for low-prevalence and high-prevalence populations, respectively. Conclusion: All test interventions for HCV screening are cost-effective for the early detection of HCV infection, also achieving a reduction in mortality. Thus, implementation of screening programs for HCV should not be halted by decisions on monetary policy.
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Citation tools
Nicolás Pérez D, Morales Arráez D, Castilla Rodríguez I, Gutiérrez Nicolás F, Díaz-Flores Estévez F, de Vera González A, et all. Hepatitis C virus infection screening reduces mortality and is cost-effective independently of the intervention test. 8609/2022


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Publication history

Received: 15/01/2022

Accepted: 07/03/2022

Online First: 14/03/2022

Published: 12/12/2022

Article revision time: 48 days

Article Online First time: 58 days

Article editing time: 331 days


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