Background/Aims The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach.
Methods We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction.
Results Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal.
Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.
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HCV self-testing: Bridging screening gaps and ensuring cost-effectiveness for both high-risk and universal populations: Correspondence to editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of dis Gyeongseon Shin, Beom Kyung Kim, SeungJin Bae, Hankil Lee, Sang Hoon Ahn Clinical and Molecular Hepatology.2025; 31(2): e163. CrossRef
Universal self-testing as a cost-effective weapon to eliminate hepatitis C virus in the Republic of Korea: Editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiven Eun Sun Jang Clinical and Molecular Hepatology.2025; 31(2): 596. CrossRef
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Background/Aims Obstacles exist in facilitating hepatitis C virus (HCV) care cascade. To increase timely and accurate diagnosis, disease awareness and accessibility, in-hospital HCV reflex testing followed by automatic appointments and a late call-back strategy (R.N.A. model) was applied. We aimed to compare the HCV treatment rate of patients treated with this strategy compared to those without.
Methods One hundred and twenty-five anti-HCV seropositive patients who adopted the R.N.A. model in 2020 and another 1,396 controls treated in 2019 were enrolled to compare the gaps in accurate HCV RNA diagnosis to final treatment allocation.
Results The HCV RNA testing rate was significantly higher in patients who received reflex testing than in those without reflex testing (100% vs. 84.8%, P<0.001). When patients were stratified according to the referring outpatient department, a significant improvement in the HCV RNA testing rate was particularly noted in patients from non-hepatology departments (100% vs. 23.3%, P<0.001). The treatment rate in HCV RNA seropositive patients was 83% (83/100) after the adoption of the R.N.A. model, among whom 96.1% and 73.9% of patients were from the hepatology and non-hepatology departments, respectively. Compared to subjects without R.N.A. model application, a significant improvement in the treatment rate was observed for patients from non-hepatology departments (73.9% vs. 27.8%, P=0.001). The application of the R.N.A. model significantly increased the in-hospital HCV treatment uptake from 6.4% to 73.9% for patients from non-hepatology departments (P<0.001).
Conclusions The care cascade increased the treatment uptake and set up a model for enhancing in-hospital HCV elimination.
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