In addition, they found that counselor-initiated routine, rapid HCV testing had an ICER of $71,000 per additional QALY, and that counselor-initiated testing was cost-effective (defined as ICER <$100,000 per QALY) in communities in which the prevalence of PWID was >.59%, HCV prevalence among PWID was >16%, and the HCV reinfection rate was >26 cases per 100 person-years. Deterministic and probabilistic sensitivity analyses revealed that routine rapid testing was the optimal strategy in 90% of all simulations performed.
“Our study specifically focused on young adults at high-risk for HCV, namely persons who inject drugs, who are seen in neighborhoods with a high reported rate of HCV,” Dr. Assoumou explained. “We are now looking at different testing approaches in other groups at risk [for HCV].”
In their concluding remarks, she and her colleagues note, “We show that routine testing provides the most clinical benefit and best value for money in an urban community health setting where HCV prevalence is high. Centers should consider either routine rapid testing by a counselor/tester or provide reflex HCV RNA following venipuncture testing. Future studies are needed to define the programmatic effectiveness of HCV treatment among youth, and testing and treatment acceptability in this population.”
Funding for this study was provided via grants from the National Institute on Drug Abuse and the National Institute of Allergy and Infectious Diseases.
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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