title: Is HCV genotyping cost-effective even when the prevalences of genotypes 2 and 3 are low?
abstract: OBJECTIVE
  The management of chronic hepatitis C virus (HCV) infection is costly. Genotyping determines the indication, probability of response, and duration of treatment and the dose of ribavirin. Although genotyping is accepted cost-effective, the cost of genotyping in all of the patients to find out a minority may offset the gain. The present study aimed; (1) to determine the frequency rate of HCV genotypes and (2) to compare the cost of HCV treatment tailored according to the genotype versus that planned supposing it to be genotype 1.
  
  
  METHODS
  Six centers were included into the study. Name, age, genotype, and serotype of each patient were entered. For genotyping, HCV-RNA was extracted by acid-guanidium-phenol-chloroform method. Cost of genotyping, HCV-RNA studies and the treatment with pegylated interferon and ribavirin was estimated. The cost was determined according to two scenarios: (A) To manage patients as if all had genotypes other than 2-3. (B) To manage them after determining the geno type. The management was assumed to be made by current guidelines.
  
  
  RESULTS
  The data of 834 patients were analyzed: Genotypel was predominant: 730 (87.5%). The rest was composed of G2:26 (3.1%), G3:26 (3.1%), G4:14 (1.7%), mixed: 13 (1.6%), undetermined: 25(3%). The cost of approach A (for 100 patients) was 1,718,200 USD; that of approach B (for 100 patients) was 1,671,900 USD. With genotype targeted therapy, every 100 patient would save 46,300 USD.
  
  
  CONCLUSIONS
  The prevalent genotype in our country is genotypel. The sum of genotypes 2 and 3 corresponds to 6%. Genotyping HCV and tailoring the treatment thereafter are cost-effective even in the countries where prevalence of these genotypes is low.
authors: Marmara University Institute of Gastroenterology, Istanbul.
authors: Veysel
authors: V
authors: Tahan
authors: Resat
authors: R
authors: Ozaras
authors: Cetin
authors: C
authors: Karaca
authors: Suleyman
authors: S
authors: Uraz
authors: Fatih
authors: F
authors: Eren
authors: Ahmet
authors: A
authors: Danalioglu
authors: Erol
authors: E
authors: Avsar
authors: Salih
authors: S
authors: Turkoglu
authors: Kenan
authors: K
authors: Midilli
authors: Fehmi
authors: F
authors: Tabak
authors: Recep
authors: R
authors: Ozturk
authors: Ali
authors: A
authors: Mert
authors: Hakan
authors: H
authors: Senturk
authors: Nurdan
authors: N
authors: Tozun
mesh_terms: D003362:Cost-Benefit Analysis; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics; D006801:Humans; D012367:RNA, Viral / Q000032:analysis
chemical_list: D012367:RNA, Viral