Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan
Background and purpose: Hepatitis C virus (HCV) core antigen is highly sensitive and specific in viremic HCV diagnosis. This study evaluated the cost-effectiveness of HCV core antigen (HCVcAg) in community-based screening for active HCV infection. Methods: Between 2017/07 and 2018/07, community-base...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664619302244 |
| _version_ | 1811343867368177664 |
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| author | Jing-Houng Wang Chien-Hung Chen Chia-Ming Chang Wen-Chin Feng Chih-Yi Lee Sheng-Nan Lu |
| author_facet | Jing-Houng Wang Chien-Hung Chen Chia-Ming Chang Wen-Chin Feng Chih-Yi Lee Sheng-Nan Lu |
| author_sort | Jing-Houng Wang |
| collection | DOAJ |
| description | Background and purpose: Hepatitis C virus (HCV) core antigen is highly sensitive and specific in viremic HCV diagnosis. This study evaluated the cost-effectiveness of HCV core antigen (HCVcAg) in community-based screening for active HCV infection. Methods: Between 2017/07 and 2018/07, community-based screenings for active HCV infection with two-step (anti-HCV for screening and HCVRNA for diagnosis) and one-step processes (HCVcAg for screening and diagnosis) were conducted in two districts in Kaohsiung City. While HCVcAg test was positive at ≥3 fmol/L, the lowest level of HCV-RNA detection was 12 IU/mL. We analyzed the cost-effectiveness of two algorithms in identifying active HCV infection. Results: There were two large-scale screenings using the two-step process with a total of 2452 residents enrolled; while six hundred and forty-four residents participated in continuous small-scale screening with the one-step process. The prevalence of anti-HCV and positive HCVcAg was 3.4% and 2.8%. The viremic rate was 1.4% and 2.8% for two- and one-step processes (p < 0.001). While all positive HCVcAg were viremic, 42.4% of positive anti-HCV patients had viremia. The positive predictive value was 42.2% and 100% for two- and one-step processes in detecting active HCV infection (p < 0.001). In identifying one active HCV infection, the cost was $755.3 and $711.1 dollars for two- and one-step processes respectively. Conclusion: Compared to the two-step process in community-based screening, continuous screening with the HCVcAg test as a one-step tool for active HCV infection was cost-effective in areas with low seroprevalence of HCV in Taiwan. Keywords: Hepatitis C virus core antigen, Community-based screening, Cost-effectiveness |
| first_indexed | 2024-04-13T19:37:39Z |
| format | Article |
| id | doaj.art-3205d5c240014f29bee92a691e60e0d0 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-13T19:37:39Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-3205d5c240014f29bee92a691e60e0d02022-12-22T02:32:59ZengElsevierJournal of the Formosan Medical Association0929-66462020-01-011191504508Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in TaiwanJing-Houng Wang0Chien-Hung Chen1Chia-Ming Chang2Wen-Chin Feng3Chih-Yi Lee4Sheng-Nan Lu5Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County and National Taiwan University College of Medicine, Taipei City, TaiwanLinyuan Public Health Center, Kaohsiung City, TaiwanDaliao Public Health Center, Kaohsiung City, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital-Chiayi Branch, Chiayi County, TaiwanDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; Division of Hepatogastroenerolgy, Department of Internal Medicine, Chang Gung Memorial Hospital-Chiayi Branch, Chiayi County, Taiwan; Corresponding author. Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Chiayi Branch, Chiayi County, 6. West Sec., Chiapu Road, Putzu City, Chiayi Hsien, Taiwan. Fax: +886 5 3623002.Background and purpose: Hepatitis C virus (HCV) core antigen is highly sensitive and specific in viremic HCV diagnosis. This study evaluated the cost-effectiveness of HCV core antigen (HCVcAg) in community-based screening for active HCV infection. Methods: Between 2017/07 and 2018/07, community-based screenings for active HCV infection with two-step (anti-HCV for screening and HCVRNA for diagnosis) and one-step processes (HCVcAg for screening and diagnosis) were conducted in two districts in Kaohsiung City. While HCVcAg test was positive at ≥3 fmol/L, the lowest level of HCV-RNA detection was 12 IU/mL. We analyzed the cost-effectiveness of two algorithms in identifying active HCV infection. Results: There were two large-scale screenings using the two-step process with a total of 2452 residents enrolled; while six hundred and forty-four residents participated in continuous small-scale screening with the one-step process. The prevalence of anti-HCV and positive HCVcAg was 3.4% and 2.8%. The viremic rate was 1.4% and 2.8% for two- and one-step processes (p < 0.001). While all positive HCVcAg were viremic, 42.4% of positive anti-HCV patients had viremia. The positive predictive value was 42.2% and 100% for two- and one-step processes in detecting active HCV infection (p < 0.001). In identifying one active HCV infection, the cost was $755.3 and $711.1 dollars for two- and one-step processes respectively. Conclusion: Compared to the two-step process in community-based screening, continuous screening with the HCVcAg test as a one-step tool for active HCV infection was cost-effective in areas with low seroprevalence of HCV in Taiwan. Keywords: Hepatitis C virus core antigen, Community-based screening, Cost-effectivenesshttp://www.sciencedirect.com/science/article/pii/S0929664619302244 |
| spellingShingle | Jing-Houng Wang Chien-Hung Chen Chia-Ming Chang Wen-Chin Feng Chih-Yi Lee Sheng-Nan Lu Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan Journal of the Formosan Medical Association |
| title | Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan |
| title_full | Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan |
| title_fullStr | Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan |
| title_full_unstemmed | Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan |
| title_short | Hepatitis C virus core antigen is cost-effective in community-based screening of active hepatitis C infection in Taiwan |
| title_sort | hepatitis c virus core antigen is cost effective in community based screening of active hepatitis c infection in taiwan |
| url | http://www.sciencedirect.com/science/article/pii/S0929664619302244 |
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