Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Intervention Strategies to Prevent & Treat HBV

Open Forum Infect Dis; ePub 2018 Dec 26; Chahal, et al

In 6 high-risk populations in the US, a program to screen and treat or vaccinate was cost-effective in reducing hepatitis B virus (HBV) burden, a recent study found. Researchers conducted a cost-effective analysis of 3 intervention strategies to prevent and treat HBV among the following high-risk populations: foreign-born Asian/Pacific Islanders (API), Africa-born blacks (AbB), incarcerated, refugees, persons who inject drugs (PWID), and men who have sex with men (MSM). They studied 3 strategies: 1) screen for HBV infection and treat infected (treatment only); 2) screen for HBV susceptibility and vaccinate susceptible (vaccinate-only); and 3) screen for both and follow-up appropriately (inclusive). They found:

  • Vaccination-only and treatment-only strategies had incremental cost-effectiveness ratios (ICERs) of $6,000‒$21,000 per quality-adjusted life year (QALY) gained, respectively.
  • The inclusive strategy added minimal cost with substantial clinical benefit, with the following costs per QALY gained vs no intervention: incarcerated $3,203, PWID $8,514, MSM $10,954, AbB $17,089, refugees $17,432, and API $18,009.
  • Clinical complications dropped in the short- and intermediate and long-term.

Citation:

Chahal HS, Peters MG, Harris AM, McCabe D, Volberding P, Kahn JG. Cost-effectiveness of hepatitis B virus infection screening and treatment or vaccination in six high-risk populations in the US. [Published online ahead of print December 26, 2018]. Open Forum Infect Dis. doi:10.1093/ofid/ofy353.