Change in Hepatitis Screening May Save Lives, Money
FRIDAY Nov. 4, 2011 -- Primary care-based screening for hepatitis C in people born between 1945 and 1965 is cost-effective and lifesaving, a new study says.
This type of screening could identify more than 800,000 undiagnosed cases of hepatitis C infection in the United States and save thousands of lives each year, according to the researchers.
About 1.5 percent of people in the United States are infected with the hepatitis C virus (HCV), which can cause inflammation and permanent liver damage. As many as three-quarters of people with HCV don't know they're infected.
In 2005, HCV infection caused up to 13,000 deaths in the United States, but that number could nearly triple by 2030 if current recommendations for HCV diagnosis and treatment remain unchanged, according to the study authors.
Developing hepatitis C today is less likely today because of improved screening of the universal blood supply and better infection-control techniques. Those considered most at risk are people born between 1945 and 1965 who may have been exposed before those advances were made.
Currently, the U.S. Centers for Disease Control and Prevention recommends HCV screening only for people with certain high-risk health or lifestyle behaviors, including a history of injection drug use, a blood transfusion before 1992 or being a chronic hemodialysis patient.
For this study, the researchers developed a computer model to examine the impact of primary care-based screening of people born between 1945 and 1965. Compared to the current strategy of screening high-risk individuals, primary care-based screening followed by standard treatment would result in 82,300 fewer deaths per year at a cost of $15,700 per quality adjusted life-year (QALY) gained.
Adding direct acting antiviral drug treatment to standard treatment (pegylated interferon and ribavirin) would prevent about 121,000 deaths per year at a cost of $35,000 per QALY gained.
The study, published online in the journal Annals of Internal Medicine, will be presented at the American Association for the Study of Liver Diseases meeting, Nov. 4 to 8.
"First, the strategy would identify over 800,000 people with hepatitis C if it were fully implemented, and second, the strategy is at least as cost-effective as many routinely administered preventive practices such as breast cancer screening or colorectal screening," lead author David Rein, principal research scientist of the Public Health Research Division at the University of Chicago National Opinion Research Center, said in a journal news release.
Posted: November 2011