Cost-effectiveness of Strategies to Identify Children with Perinatally Acquired Hepatitis C Infection

Details

• Alternative Title:
  J Pediatr
• Personal Author:
  Hall, Eric W. ; Panagiotakopoulos, Lakshmi ; Wester, Carolyn ; Nelson, Noele ; Sandul, Amy L
• Description:
  Objectives:
  
  We aimed to determine the optimal testing strategy to identify children with perinatally acquired hepatitis C virus (HCV) infection.
  
  Study Design:
  
  We used a decision-tree framework with a Markov disease progression model to conduct an economic analysis of four strategies, based on combinations of type and timing of test: Anti-HCV with reflex to HCV RNA at 18 months among children known to be perinatally exposed (ie, baseline comparison strategy); HCV RNA testing at 2–6 months among infants known to be perinatally exposed (Test Strategy 1); universal anti-HCV with reflex to HCV RNA at 18 months among all children (Test Strategy 2); universal HCV RNA testing at 2–6 months among all infants (Test Strategy 3). We estimated total cost, quality-adjusted life years (QALYs), and disease sequalae for each strategy.
  
  Results:
  
  Each of the three alternative testing strategies resulted in an increased number of children tested and improved health outcomes. HCV RNA testing at 2–6 months (Test Strategy 1) was cost-saving and resulted in a population-level difference in cost of $469,671. The two universal testing strategies resulted in an increase in QALYs and an increase in total costs.
  
  Conclusions:
  
  Testing of perinatally exposed infants at age 2–6 months with a single HCV RNA test will reduce costs and improve health outcomes, preventing morbidity and mortality associated with complications from perinatal HCV infections.
  
  
• Subjects:
  Child Cost-Benefit Analysis Female Hepacivirus Hepatitis C Humans Infant Pregnancy Quality-Adjusted Life Years RNA
• Keywords:
  Diagnosis Economic Evaluation Hepatitis C Virus Maternal Antibodies
• Source:
  J Pediatr. 258:113409
• Pubmed ID:
  37023948
• Pubmed Central ID:
  PMC10448738
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  258
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:75920b8dc7dc8ebafd12f69d93183b17406ca68b8c3cd4a584cf70fd90da7718
• Download URL:
  https://stacks.cdc.gov/view/cdc/132369/cdc_132369_DS1.pdf
• File Type:
  [PDF - 819.25 KB ]