Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Expanded Age-Based HCV Testing in US

Clin Infect Dis; ePub 2018 Feb 6; Barocas, et al

One-time hepatitis C virus (HCV) testing in persons aged ≥18 years is cost-effective and leads to improved clinical outcomes while identifying more persons with HCV than the current birth cohort recommendations. This according to study that used a simulation of HCV to estimate the effectiveness and cost-effectiveness of HCV testing strategies: 1) standard of care (SOC) – recommendations for 1-time testing for all persons born 1945-1965, 2) recommendation for 1-time testing for adults aged ≥40 years, 3) ≥30 years, and 4) ≥18 years. Researchers found:

  • Expanded age-based hepatitis C virus (HCV) testing strategies increased US population lifetime case identification and cure rates, with the greatest increases in the ≥18 years strategy.
  • Compared to the SOC, this strategy resulted in an estimated 256,000 additional infected persons identified and 280,000 additional cures at the lowest cost per QALY gained (ICER=$28,000/QALY).


Barocas JA, Tasillo A, Yazdi GE, et al. Population level outcomes and cost-effectiveness of expanding the recommendation for age-based hepatitis C testing in the United States. [Published online ahead of print February 6, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy098.

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