Pretreatment Evaluation of Chronic Hepatitis C: Risks, Benefits, and Costs

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Pretreatment Evaluation of Chronic Hepatitis C: Risks, Benefits, and Costs

Journal of the American Medical Association Online (12/23/98- 12/30/98) Vol. 280, No. 24, P. 2088
Wong, John B.; Bennett, William G.; Koff, Raymond S.; et al.

Dr. John B. Wong and colleagues evaluated pretreatment strategies for people with chronic hepatitis C who took interferon alfa-2b, which is costly and has a low-likelihood of long-term response. The researchers analyzed the prevalence of genotypes, viral load, and histological characteristics in relation to sustained response rates to treatment using a Markov model involving a hypothetical population of patients with elevated serum alanine aminotransferase levels and chronic hepatitis C. RNA testing for hepatitis C virus was marginally cost-effective, but would miss 36 percent of sustained responders, according to the findings. Empirical interferon treatment was also marginally cost-effective and had the advantage of reaching all potential sustained responders, while liver biopsy was not as cost effective and failed to reach 6 percent of sustained responders.

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