BOSTON – New research from Boston Medical Center found that national guidelines recommending twice-yearly screening for the Hepatitis C virus (HCV) in patients with kidney disease undergoing hemodialysis do not appear to be a cost-effective use of health care resources. Published in the Journal of the American Society of Nephrology, researchers highlight that the resources currently being used to provide frequent HCV screenings in dialysis centers could be put to better use providing other types of care to patients. The authors call for a reevaluation of the frequency of HCV screening in this population.
In the past 10 years, there have been several outbreaks of acute HCV infection in hemodialysis centers. The goal of current HCV screening guidelines for hemodialysis patients, therefore, is to reduce or eliminate HCV transmission within dialysis units. Current guidelines are expert opinion-based, and this is the first study to determine the best HCV screening frequencies in dialysis units.
Researchers discovered that testing for HCV at the beginning of hemodialysis leads to 80% of infected people being cured and prevents many liver-related deaths. Screening once every 2 years cures even more people and reduces liver-related deaths by an additional 52%. Both of these strategies are cost-effective. However, screening every year or every 6 months – as guidelines currently recommend – greatly increases cost with very little health benefit.
“We hope our findings can help improve HCV care for dialysis patients, by ensuring that centers are screening for HCV at entry to a center and ideally every 2 years. More frequent screenings may not be the best use of our healthcare resources,” said Rachel Epstein, MD, MSC, lead author, adult and pediatric infectious disease physician at Boston Medical Center, and assistant professor of medicine at Boston University Chobanian and Avedisian School of Medicine.
Researchers hope their findings will be used to guide future HCV screening recommendations for hemodialysis centers.