Expanding Hepatitis C testing to all adults is cost-effective and improves outcomes

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According to a new study, screening all adults for hepatitis C (HCV) is a cost-effective way to improve clinical outcomes of HCV and identify more infected people compared to current recommendations. Using a simulation model, researchers from Boston Medical Center, Massachusetts General Hospital (MGH) and Stanford University found that this expanded screening would increase life expectancy and quality of life while remaining cost-effective.

The Centers for Disease Control and Prevention (CDC) currently recommends HCV testing for people born between 1945 and 1965, the highest risk population in the U.S. However, recent trends have shown a higher incidence rate of HCV among young people. To address this gap in testing, the researchers created simulations to estimate the effectiveness of HCV testing strategies among different age groups. They compared effects of the current testing recommendations; of testing people over 40 years old or over 30 years old, and of testing all adults over 18 years old. All strategies included the current recommendations for targeted testing of high-risk individuals, such as people who inject drugs.

The study found that screening all adults for would identify more than 250,000 additional people with HCV, increase cure rates from 41 to 61 percent, and reduce death rates for HCV-attributable diseases more than 20 percent, compared with current recommendations.

“When we expanded testing, the results were compelling,” says Joshua Barocas, MD, lead author on the study, an infectious disease physician at MGH and an instructor in medicine at Harvard Medical School. “Changing the current recommendations could have a major public health impact, improving the quality of life for young people with HCV, and reducing death rates.”