Efectividad clínica, seguridad y evaluación económica del cribado poblacional de hepatitis C. Revisión sistemática ; Clinical effectiveness, safety, and economic assessment of mass screening for hepatitis C Systematic review

The first Global Health Sector Strategy on viral hepatitis 2016-2021 provided the initial roadmap for the elimination of viral hepatitis as a public health problem by 2030. With the development of new therapeutic strategies that allow the elimination of the virus, the hypothesis is raised that population-based screening could increase the cases diagnosed in the initial stages of the disease, contributing to early treatment of infected people, avoiding the progression of chronic liver disease and its transmission.The localized evidence does not demonstrate the clinical effectiveness of population-based screening for hepatitis C in reducing mortality, morbidity and/or its influence on quality of life. Not enough studies were identified to assess the safety of the population screening strategy. The compiled economic analyzes, bearing in mind the methodological limitations they present, show that the screening of the highest-risk subgroups would be the most efficient strategy. While population screening followed by treatment could be an efficient medium and long-term strategy to achieve the goal of eliminating viral hepatitis, it requires significant financial investment in health systems. ; La primera estrategia mundial contra las hepatitis víricas, propone como objetivo la eliminación, antes de 2030, de la amenaza que supone para la salud pública la hepatitis C, por lo que parece razonable evaluar el cribado poblacional para esta infección como herramienta de diagnóstico precoz que permita el tratamiento temprano e impida la transmisión. Hemos estudiado esta intervención mediante la realización de una revisión sistemática de la literatura entre 2013 y septiembre de 2020, en cuanto a variables clínicas y económicas. La evidencia localizada no demuestra la efectividad clínica del cribado poblacional de la hepatitis C en la reducción de la mortalidad, la morbilidad y/o su influencia sobre la calidad de vida. Los análisis económicos recopilados, con las limitaciones metodológicas que presentan, muestran que el cribado ...