Universal 1-time screening for chronic hepatitis C virus (HVC) infection is cost-effective compared with either no screening or birth cohort-based screening alone, a new study found. Researchers used a Markov state transition model to estimate the effects of universal 1-time screening of US adults aged ≥18 years, compared with the current guideline-based strategy of screening adults born from 1945 to 1965. They compared potential outcomes of 1-time universal screening of adults or birth cohort screening followed by antiviral treatment of those with HCV infection vs no screening. They found:

• 1-time screening of US residents with general population prevalence of HCV antibody >0.07% cost <$50,000/quality-adjusted life years (QALY) compared with a strategy of no screening.
• Compared with 1-time birth cohort screening, universal 1-time screening and treatment cost $11,378/QALY gained.
• Universal screening was cost-effective vs birth control screening when the prevalence of HCV antibody positivity was >0.07% among adults not in the cohort born from 1945 to 1965.