ArticleJournal of the Pediatric Infectious Diseases Society2026
Cost-Effectiveness of One-Time Universal Childhood Hepatitis C Screening in the United States.
Article in Journal of the Pediatric Infectious Diseases Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatitis C Virus (HCV) in pregnancy has increased, leading to increased perinatally exposed infants. Although universal HCV screening in pregnancy is recommended, pediatric cases remain undiagnosed. We examine the cost-effectiveness of universal HCV screening among children at age 2 and 10, when other routine blood testing is recommended.
methodsAn HCV natural history Markov model evaluated the cost-effectiveness of universal HCV screening independently at ages 2 and 10 compared to the currently recommended risk-based screening of children born to those with HCV. Based on previous literature, we assumed a 0.05% pediatric HCV chronic prevalence (0.73% chronic prevalence among pregnant persons and 7.2% vertical transmission). In the status-quo scenario, we assumed 23% of children with prenatal HCV exposure were screened. We assessed costs (United States Dollar), quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER, $ per QALY gained) compared to a willingness-to-pay threshold (WTP) of $50 000/QALY. We explored parameter uncertainty, including pediatric HCV chronic prevalence and screening rates, in multiple sensitivity analyses.
resultsUniversal HCV screening at age 2 was cost-effective (ICER = $8774/QALY gained) compared to the status-quo risk-based screening. The lowest pediatric HCV chronic prevalence in which universal screening remained cost-effective under a WTP of $50 000/QALY was 0.007%. At age 10, universal screening was cost-effective compared to risk-based screening (ICER = $4404/gained) and was cost-effective at the lowest HCV prevalence in children of 0.006%. Models at both age 2 and 10 were robust to sensitivity analyses.
conclusionsUniversal HCV screening in childhood is cost-effective. Guidelines should consider recommending universal screening nationally, particularly if it can be conducted along with other routine pediatric blood draws.
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