Early treatment of Chronic Hepatitis C in Children prevents Complications: Study

Emma Greenaway and colleagues from the Division of Gastroenterology Hepatology and Nutrition, Hospital for Sick Children, Toronto, Ontario, Canada and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada carried out this study to evaluate the cost-effectiveness of treating young children with chronic hepatitis C virus (HCV) with new direct-acting antivirals.

A state-transition model of chronic HCV was developed to conduct a cost-effectiveness analysis comparing treatment at age 6 years vs delaying treatment until age 18 years. Model inputs were derived from recently conducted systematic reviews, published literature, and government statistics.

Medical care costs were obtained from linked population level laboratory and administrative data (Ontario, Canada). Outcomes are expressed in expected quality-adjusted life-years and costs (CAD$). Analysis included a base-case to estimate the expected value and one-way and probabilistic sensitivity analyses to evaluate the impact of uncertainty of the model inputs.

The results showed that -

a. After 20 years, treating 10 000 children early would prevent 330 cases of cirrhosis, 18 cases of hepatocellular carcinoma, and 48 liver-related deaths.

b. The incremental cost-effectiveness ratio of early treatment compared to delayed treatment was approximately $12 690/quality-adjusted life-years gained and considered cost-effective.

c. Model results were robust to variation in fibrosis progression rates, disease state-based costs, treatment costs, and utilities.

Therefore, the authors concluded that "Delaying treatment until age 18 years results in an increased lifetime risk of late-stage liver complications. Early treatment in children is cost effective. This work supports clinical and health policies that broaden HCV treatment access to young children."

Hence, it was further added that treatment of Chronic Hepatitis C in Young Children Reduces Adverse Outcomes and Is Cost-Effective Compared with Deferring Treatment to Adulthood.