Cost-effectiveness of preimmunization hepatitis B screening in high-risk adolescents

Abstract

SYNOPSISObjective. The goals of this study were to estimate seroprevalence of prior hepatitis B infection among high-risk adolescents and to determine the costeffectiveness of prevaccination immunity screening.Methods. The authors computed a "break-even" seroprevalence level calculated from current vaccine and administration costs. They then conducted a seroprevalence study of hepatitis B core antibody using sera previously submitted for syphilis serology from four-hundred adolescent and adult clients of sexually transmitted disease clinics. Finally, the authors compared age groupspecific seroprevalence rates to the computed break-even seroprevalence.Results. Levels of prior hepatitis B infection for all age groups were lower than the break-even seroprevalence standard from which cost-effectiveness was calculated.Conclusions. From the findings of this study, the authors concluded that routine preimmunization screening for prior hepatitis B infection would not be cost-effective for this population.

Immunization Needs of Chronic Liver Disease Patients Seen in Primary Care Versus Specialist Settings

“…Rates of hepatitis A and B immunity have important implications for the establishment of prescreening programs. Depending on cost assumptions, seroprevalence rates exceeding 17 to 22% are required to justify prescreening prior to vaccinating against either hepatitis A or hepatitis B individually (16,37). When immunizing against both hepatitis A and hepatitis B using the bivalent vaccine, prescreening is cost-effective when >40% have prior hepatitis A or B exposure (38).…”

Evidence-based clinical guidelines for immigrants and refugees

“…Cost-effectiveness studies have shown that the "breakpoint seroprevalence" of prior hepatitis B infection, above which prevaccination screening for prior immunity is worth doing, ranges from 17% to 35%. 186,187 Therefore, it would likely be cost-effective to do prevaccination screening for prior infection among adult immigrants originating from countries that are moderately to highly endemic for hepatitis B. 188 In two studies of refugee children with mean ages of 7 and 10 years, respectively, from several different world regions (Africa, former Soviet Union and Yugoslavia, Asia), the seroprevalence of hepatitis B surface antigen was 6.5% and 4%, respectively, and the prevalence of prior infection was 30% and 21%, respectively.…”

Risk perceptions and behavioral intentions for Hepatitis B: how do young adults fare?

“…In the United States, >1 million people are chronic carriers of Hepatitis B. Roughly 100 000-150 000 persons become acutely infected with the virus and 5000 die from its effects each year [1,2]. Chronic Hepatitis B is associated with significant morbidity, including cirrhosis, liver cancer and liver failure [3].…”