Removing hepatitis C antibody testing for Australian blood donations: A cost-effectiveness analysis

被引：3

作者：

Cheng, Qinglu ^{[1
]}

Hoad, Veronica C. C. ^{[2
]}

Choudhury, Avijoy Roy ^{[3
]}

Seed, Clive R. R. ^{[2
]}

Bentley, Peter ^{[2
,3
]}

Shih, Sophy T. F. ^{[1
]}

Kwon, Jisoo A. A. ^{[1
]}

Gray, Richard T. T. ^{[1
]}

Wiseman, Virginia ^{[1
,4
]}

机构：

[1] UNSW Sydney, Kirby Inst, Sydney, Australia

[2] Australian Red Cross Lifeblood, Perth, WA, Australia

[3] Univ Western Australia, UWA Med Sch, Perth, WA, Australia

[4] London Sch Hyg & Trop Med, Dept Global Hlth & Dev, London, England

来源：

VOX SANGUINIS | 2023年 / 118卷 / 06期

基金：

英国医学研究理事会;

关键词：

blood donation testing; blood safety; cost effectiveness; hepatitis C; HUMAN-IMMUNODEFICIENCY-VIRUS; TRANSFUSION; IMPACT;

D O I：

10.1111/vox.13429

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and Objectives: The risk of transfusion-transmitted hepatitis C virus (HCV) infections is extremely low in Australia. This study aims to conduct a cost-effectiveness analysis of different testing strategies for HCV infection in blood donations.Materials and Methods: he four testing strategies evaluated in this study were universal testing with both HCV antibody (anti-HCV) and nucleic acid testing (NAT); anti-HCV and NAT for first-time donations and NAT only for repeat donations; anti-HCV and NAT for transfusible component donations and NAT only for plasma for further manufacture; and universal testing with NAT only. A decision-analytical model was developed to assess the cost-effectiveness of alternative HCV testing strategies. Sensitivity analysis and threshold analysis were conducted to account for data uncertainty.Results: The number of potential transfusion-transmitted cases of acute hepatitis C and chronic hepatitis C was approximately zero in all four strategies. Universal testing with NAT only was the most cost-effective strategy due to the lowest testing cost. The threshold analysis showed that for the current practice to be cost-effective, the residual risks of other testing strategies would have to be at least 1 HCV infection in 2424 donations, which is over 60,000 times the baseline residual risk (1 in 151 million donations).Conclusion: The screening strategy for HCV in blood donations currently implemented in Australia is not cost-effective compared with targeted testing or universal testing with NAT only. Partial or total removal of anti-HCV testing would bring significant cost savings without compromising blood recipient safety.

引用

页码：471 / 479

页数：9

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