Increased Hepatitis C Screening May Cause More Harm Than Good

Study warns there is no testing to support a net clinical benefit.

While a number of organizations have recommended increased screening for hepatitis C virus (HCV), a recent study warns this may not have the intended positive effect.

In a study published this week in the British Medical Journal, researchers note that there has not been any testing performed to evaluate if ramped up HCV screening programs will cause a net clinical benefit or harm. The researchers note that physicians "should resist screening until we have strong evidence that antiviral therapy is clinically effective and the benefits outweigh the harms."

The US Centers for Disease Control and Prevention in 2012 recommended HCV screening for everyone born from 1945 to 1965, as three-quarters of the HCV patient population are within that age range. Wide scale screening is also recommended by the US Preventative Services Task Force and the World Health Organization, with the viewpoint that screening could potentially save hundreds of thousands of lives through the prevention of end stage liver disease.

For the current study, however, researchers argue that the majority of HCV patients "will not develop end stage liver disease and will therefore be unnecessarily treated."

The study also questions utilizing surrogate markers in clinical trials to project the long term effect from treatments. Additionally, the study notes that it remains unproven how well a therapy can reduce the incidence of end stage liver disease.

"Given the uncertainty about the validity of the surrogate markers, the lack of evidence regarding clinical outcomes of treatment or of screening strategies, and the adverse events caused by the newer regimens, screening may be premature," the study authors wrote. "Physicians should resist screening until we have strong evidence that antiviral therapy is clinically effective and the benefits outweigh the harms.”