Screening for hepatitis C in intravenous drug users and genito-urinary clinic attendees
Leal P, Stein K
Record ID 31998008899
The authors consider whether screening and interferon alpha (IFNa) treatment for hepatitis C (HCV) should be offered to intravenous drug users (IVDUs) and genito-urinary medicine (GUM) clinic attendees.
Authors' results and conclusions: There is excellent evidence that IFNa is effective in producing sustained normalisation of liver function and, by inference, eradicating HCV. Evidence for long term benefits comes from modelling studies based on information about HBV or non-A non-B hepatitis and is less robust. Using estimates from a UK modelling study of the time in ill health avoided through treatment with IFNa, the authors calculated the benefits of avoiding the consequences of HCV for the people identified and successfully treated through screening. These were combined with the likely costs of screening and 'savings' from averting the consequences of HCV disease.
Authors' recommendations: The authors conclude that the case for screening is not proven: evidence of the benefits, harms and costs of a screening programme in either population is inadequate. Although the evidence presented shows that a prevalence round of screening in intravenous drug users could be cost-effective, there is too much uncertainty surrounding this to reach a definite conclusion. In particular, the evidence relies on assumptions regarding the natural history of hepatitis C and likely adherence to diagnosis and treatment that may not be valid.
Authors' methods: Economic modelling
Project Status: Completed
URL for project: http://www.wihrd.soton.ac.uk
Year Published: 1998
English language abstract: An English language summary is available
Publication Type: Not Assigned
- Costs and Cost Analysis
- Mass Screening
- Substance Abuse, Intravenous
- Hepatitis C
Organisation Name: Wessex Institute for Health Research and Development
Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662
Copyright: Wessex Institute for Health Research and Development (WIHRD)
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