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. Author manuscript; available in PMC: 2024 Jul 1.
Published in final edited form as: J Pediatr. 2023 Apr 4;258:113409. doi: 10.1016/j.jpeds.2023.113409

Table 6.

Population-level results1 from a scenario sensitivity analysis using data from Ades et al2 for HCV testing strategies among a cohort of children, United States, 2022.

Testing known exposed children3
 Universal testing of all children
Outcome Anti-HCV with reflex
to HCV RNA at 18
months4
(Comparison)		 HCV RNA test at 2-6
months5
(Test Strategy 1)		 Anti-HCV with reflex
to HCV RNA at 18
months4,6
(Test Strategy 2)		 HCV RNA test at 2-6
months5,7
(Test Strategy 3)
Total costs (2021 USD) 80,058,982 82,265,899 122,475,587 219,378,669
Testing outcomes
 Tested children 4,478 7,588 2,709,916 3,076,918
 Anti-HCV tests 4,478 0 2,709,916 0
 HCV RNA tests 391 7,588 6,254 3,076,918
Epidemiologic outcomes among perinatally exposed children
 Diagnosed HCV infections 315 555 690 1,214
 HCC cases 410 335 306 146
 DCC cases 449 375 322 151
 Liver transplants 75 62 55 27
 HCV Liver-related deaths 736 607 533 251
 Treated/cured HCV infections 489 637 724 1,052
 Total QALYs 691,536 692,465 692,998 695,033
 Total Life-years 1,807,966 1,812,814 1,815,616 1,826,263
1

Assumes 3.6 million births with 0.64% of births occurring among persons who are HCV RNA+.

2

Assuems prevalence of HCV infection among children perinatally exposed is 7.2% and 20.9% of children that are treated at age 3 would have spontaneous cleared infection without treatment.

References:

Ades AE, Gordon F, Scott K, Collins IJ, Thorne C, Pembrey L, Chappell E, Marine-Barjoan E, Butler K, Indolfi G, Gibb DM, Judd A. Overall vertical transmission of HCV, transmission net of clearance, and timing of transmission. Clin Infect Dis. 2022 Apr 11:ciac270. doi: 10.1093/cid/ciac270. Epub ahead of print. PMID: 35403676

Ades AE, Gordon F, Scott K, Collins IJ, Thorne C, Pembrey L, Chappell E, Marine-Barjoan E, Butler K, Indolfi G, Gibb DM, Judd A. Spontaneous Clearance Of Vertically Acquired Hepatitis C Infection: Implications For Testing And Treatment. Clin Infect Dis. 2022 Apr 9:ciac255. doi: 10.1093/cid/ciac255. Epub ahead of print. PMID: 35396848.

3

Assumes 44.7% of all pregnant persons are screened for HCV infection.

4

Assumes 43.0% of children born to HCV RNA+ pregnant persons attend an 18-month visit.

5

Assumes 73.5% of children born to HCV RNA+ pregnant persons attend a 2-6 month visit.

6

Assumes 75.0% of children born to pregnant persons without HCV attend an 18-month visit.

7

Assumes 85.0% of children born to pregnant persons without HCV attend a 2-6 month visit.

Abbreviations: HCV, hepatitis C virus; anti-HCV, hepatitis C virus antibody; HCC, hepatocellular carcinoma; DCC, decompensated cirrhosis; USD, United States Dollars; QALYs, quality-adjusted life-years.