The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU?EEA: A Systematic Review.pdf (960.58 kB)
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The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review.

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journal contribution
posted on 10.09.2019, 14:08 by C Greenaway, I Makarenko, CNA Chakra, B Alabdulkarim, R Christensen, A Palayew, A Tran, L Staub, M Pareek, JJ Meerpohl, T Noori, I Veldhuijzen, K Pottie, F Castelli, RL Morton
Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean 14% of cases and >50% of cases in some countries). We conducted two systematic reviews (SR) to estimate the effectiveness and cost-effectiveness of HCV screening for migrants living in the EU/EEA. We found that screening tests for HCV are highly sensitive and specific. Clinical trials report direct acting antiviral (DAA) therapies are well-tolerated in a wide range of populations and cure almost all cases (>95%) and lead to an 85% lower risk of developing hepatocellular carcinoma and an 80% lower risk of all-cause mortality. At 2015 costs, DAA based regimens were only moderately cost-effective and as a result less than 30% of people with HCV had been screened and less 5% of all HCV cases had been treated in the EU/EEA in 2015. Migrants face additional barriers in linkage to care and treatment due to several patient, practitioner, and health system barriers. Although decreasing HCV costs have made treatment more accessible in the EU/EEA, HCV elimination will only be possible in the region if health systems include and treat migrants for HCV.

Funding

This work is supported by the European Centre for Disease Prevention and Control (ECDC); FWC No ECDC/2015/016; Specific Contract No 1 ECD.5748. Manish Pareek is supported by the National Institute for Health Research (NIHR Post-Doctoral Fellowship, Manish Pareek, PDF-2015-08-102). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, or the Department of Health. A/Prof Rachael Morton is supported by an Australian NHMRC Sidney Sax Overseas Fellowship #1054216. The Parker Institute, Bispebjerg, and Frederiksberg Hospital (Christensen) is supported by a core grant from the Oak Foundation (OCAY-13-309).

History

Citation

International Journal of Environmental Research and Public Health, 2018, 15(9), 2013;

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation

Version

VoR (Version of Record)

Published in

International Journal of Environmental Research and Public Health

Publisher

MDPI

eissn

1660-4601

Acceptance date

10/09/2018

Copyright date

2018

Available date

10/09/2019

Publisher version

https://www.mdpi.com/1660-4601/15/9/2013

Notes

The following are available online at http://www.mdpi.com/1660-4601/15/9/2013/ s1, Figure S1: Analytic Framework for HCV Screening in Migrants; Table S1. Effectiveness and Cost-effectiveness Search Strategy; Tables S2–S5. Study profile GRADE; Table S6. Chronic HCV burden in migrants: the 10 migrant groups from intermediate/high HCV prevalence countries with the highest number of HCV cases in host EU/EEA countries.

Language

en