Kathleen N. Ly, M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues investigated mortality in the United States from hepatitis B virus (HBV) and HCV, in comparison with HIV. The researchers found that, from 1999 to 2007, there was a significant increase in the number of annual recorded deaths from HCV, to 15,106, and a decrease in HIV deaths, to 12,734. Factors that increased the likelihood of HCV-related deaths included chronic liver disease, HBV or HIV co-infection, alcohol-related conditions, and minority status. Factors linked to HBV-related deaths included chronic liver disease, HCV or HIV co-infection, alcohol-related conditions, and Asian or Pacific Islander descent. The majority of HBV and HCV deaths occurred in middle-aged individuals.
David B. Rein, Ph.D., from the University of Chicago, and colleagues estimated the cost-effectiveness of birth-cohort screening of adults born from 1945 through 1965 for HCV. They found that birth-cohort screening identified 808,580 additional cases of chronic HCV, compared with the status quo, with a screening cost of $2,874 per case identified. Assuming screening was followed by treatment with pegylated interferon and ribavirin, for treated patients, screening increased quality-adjusted life-years (QALYs) by 348,800, and costs by $5.5 billion, for an incremental cost-effectiveness ratio of $15,700 per additional QALY.
"Birth-cohort screening for HCV in primary care settings was cost-effective," Rein and colleagues write.
Abstract - Ly
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Abstract - Rein
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