Screening and Treatment Scenarios
We simulated 4 scenarios: 1) no screening or treatment;
2) risk-based screening, in which 18.5% (1% per
year over the next 20 years) of persons unaware of their
chronic infection were screened and offered PEG-IFNR
treatment if identified; 3) birth-cohort screening in which
all people born from 1945 through 1965 and unaware of
their HCV antibody status were offered 1-time HCV antibody
screening during their 2006 primary care visit, then
were offered PEG-IFNR treatment if identified; and 4)
an identical birth-cohort screening scenario in which patients
with genotype 1 disease who initiated treatment received
direct-acting antiviral (DAA) treatment in addition
to standard therapy and patients with genotypes 2 and 3
received PEG-IFNR. Screening occurred once to identify
prevalent cases. We did not consider repeated screenings
because birth-cohort screening is not a useful strategy to
prevent HCV incidence.