A one-time universal screening of all U.S. adults for hepatitis C infection would save lives and, in the long run, money.
Too many people infected with the hepatitis C virus (HCV) simply don’t know their disease status. As many as one in four cases of HCV infection are undiagnosed, as I pointed out in a blog earlier this year (Finding the Missing Cases), even when current federal guidelines for hepatitis C screening are closely followed.
This is why a growing number of experts support the idea of universal HCV screening. Universal screening goes beyond the current guidelines of a screening hepatitis C test for all Baby Boomers (those born between 1945 and 1965), along with testing for anyone with a risk factor (e.g., injection drug use). Instead, a one-time test for all U.S. adults would identify many more infected individuals than is found by the current screening guidelines.
This is not to say that the Baby Boomer-based screenings have not had success. For example, the 2014 HCV testing law in New York (requiring Baby Boomers to be offered HCV screening) led to an extra 270,000 people in New York getting tested for HCV. This represents a 46% increase in screening tests in one single year.
Universal screening, not surprisingly, would result in the greatest number of HCV infections being diagnosed, compared to birth cohort screening or risk factor-based screening. The estimated number of new HCV cases being identified would be 1.73 million, 1.16 million, and 0.38 million, respectively with these three screening methods.
The highly effective oral HCV treatments now available make the initial cost of universal screening transform into a cost savings in the long run, due to the prevention of later disease complications. Universal screening would result in saved lives and saved health care dollars, over time.
2016 annual meeting of the American Academy for the Study of Liver Disease
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