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Cost-effectiveness analysis of different testing strategies that use antibody levels to detect chronic hepatitis C in blood donors

dc.rights.licensehttp://creativecommons.org/licenses/by/4.0es_MX
dc.creatorVICTOR GRANADOS GARCIAes_MX
dc.creatorANA MARIA BERTHA CONTRERAS NAVARROes_MX
dc.creatorMaría del Carmen García Peñaes_MX
dc.creatorGUILLERMO SALINAS ESCUDEROes_MX
dc.creatorHla_Hla Theines_MX
dc.creatorMELVA YVONNE FLORES DUEÑASes_MX
dc.date2016
dc.date.accessioned2019-01-15T17:39:28Z
dc.date.available2019-01-15T17:39:28Z
dc.identifier.urihttp://repositorio.inger.gob.mx/jspui/handle/20.500.12100/17160
dc.descriptionAbstract: Aim. We conducted a cost-effectiveness analysis of seven hepatitis C virus (HCV) testing strategies in blood donors. Methods. Three of the seven strategies were based on HCV diagnosis and reporting guidelines in Mexico and four were from previous and current recommendations outlined by the CDC. The strategies that were evaluated determine antibody levels according to the signal-to-cut-off (S/CO) ratio and use reflex Immunoblot (IMB) or HCV RNA tests to confirm true positive (TP) cases of chronic HCV infection. Costs were calculated from the perspective of the Mexican Institute of Social Security (IMSS). A decision tree model was developed to estimate the expected number of true positive cases and costs for the base-case scenarios and for the sensitivity analyses. Results. Base-case findings indicate an extended dominance of the CDC-USA2 and CDC-USA4 options by the IMSS Mexico3 and IMSS-Mexico1 alternatives. The probabilistic sensitivity analyses results suggest that for a willingness-to-pay (WTP) range of $0–9,000 USD the IMSS-Mexico1 strategy is the most cost-effective of all strategies ($5,000 USD per TP). The IMSS-Mexico3, IMSS-Mexico2, and CDC-USA3 strategies are also cost-effective strategies that cost between $7,800 and $8,800 USD per TP case detected. The CDC-USA1 strategy was very expensive and not cost-effective. Conclusions. HCV antibody testing strategies based on the classification of two or three levels of the S/CO are cost-effective procedures to identify patients who require reflex IMB or HCV RNA testing to confirm chronic HCV infection.es_MX
dc.descriptionConclusion: Finding ways to improve the policies and procedures to confirm a chronic infection in patients with a positive Anti-HCV result is critical. Under the current risk-based screening practices, approximately two-thirds of patients will remain undiagnosed until they progress to severe hepatic cirrhosis or liver-related death [3]. Based on the results of our study, our policy recommendations for the diagnosis of chronic HCV infections would be to classify antibodies in two or three levels as measured by the S/CO ratio, and to use the follow-up procedures recommended by the IMSS-Mexico3, IMSS-Mexico2, or CDC-USA3 strategies. In high-income countries, the main risk factor for HCV is injection drug use. In low-and middle-income countries, the most important risk factors for the nosocomial transmission of HCV are unsafe practices and medical procedures, mainly due to reusing syringes for dispensing intravenous solutions and/or drugs [21, 22]. Although the risk factors for HCV infection are different in low, middle and high-income countries, there is evidence that current diagnosis practices may limit the ability to diagnose chronic HCV patients [23, 24]. Our conclusion is that HCV antibody testing strategies should be based on a classification of two or three antibody levels of the S/CO because they are the most cost-effective way to identify patients who require supplementary testing such as IMB or HCV RNA to confirm a chronic HCV infection.es_MX
dc.formatAdobe PDFes_MX
dc.languageenges_MX
dc.publisherPublic Library of Sciencees_MX
dc.relationhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154625es_MX
dc.relation.requiresSies_MX
dc.rightsAcceso Abiertoes_MX
dc.sourcePlos One (1932-6203) vol. 11 (2016)es_MX
dc.subjectBIOLOGÍA Y QUÍMICAes_MX
dc.subjectCiencias de la vidaes_MX
dc.subjectVirologíaes_MX
dc.subjectViruses_MX
dc.subjectEnfermedades del sistema digestivoes_MX
dc.subjectEnfermedades del hígadoes_MX
dc.subjectHepatitis viral humanaes_MX
dc.subjectHepatitis C crónica (diagnóstico)es_MX
dc.subjectAminoácidos, péptidos y proteínases_MX
dc.subjectProteínas sanguíneases_MX
dc.subjectInmunoproteínases_MX
dc.subjectInmunoglobinases_MX
dc.subjectAnticuerpos viraleses_MX
dc.subjectAnticuerpos de hepatitises_MX
dc.subjectDigestive system diseaseses_MX
dc.subjectLiber diseaseses_MX
dc.subjectHepatitis, viral, humanes_MX
dc.subjectHepatitis C, chronic (diagnostic)es_MX
dc.subjectAmino acids, peptides and proteinses_MX
dc.subjectBlood proteinses_MX
dc.subjectImmunoproteinses_MX
dc.subjectimmunoglobineses_MX
dc.subjectAntibodies, virales_MX
dc.subjectHepatitis antibodieses_MX
dc.titleCost-effectiveness analysis of different testing strategies that use antibody levels to detect chronic hepatitis C in blood donorses_MX
dc.typeArtículoes_MX
dc.audienceResearcherses_MX
dc.creator.idGAGV661213HDFRRC08es_MX
dc.creator.idCONA610824MJCNVN07es_MX
dc.creator.idGAPC560716MDFRXR00es_MX
dc.creator.idSAEG760111HDFLSL07es_MX
dc.creator.id0000-0003-4950-187Xes_MX
dc.creator.idFODM791021MDFLXL18es_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercvues_MX
dc.creator.nameIdentifiercurpes_MX


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