HBV pre-vaccination screening in hospital personnel: cost-effectiveness analysis.
The purpose of this study was to identify the most cost-effective method for screening subjects for hepatitis B vaccination. Such a method would ideally permit detection of all susceptible individuals at the lowest possible cost. Two-hundred-five hospital workers from the Piedmont region of Italy participated in the study. The sero-epidemiological conditions of this group with regard to hepatitis B markers was representative of hospital workers in this region as a whole. All subjects, excluding carriers, persons with anti-HBs titers greater than or equal to 10 mIU and subjects positive for anti-HBc at a 1/100 dilution, were vaccinated. Their responses were evaluated 15 days and 1 month after vaccination. The presence of a booster effect following vaccination was correlated with the immunological status of the subject at the time of pre-vaccination screening. In the light of the results obtained, 5 screening procedures and the procedure of vaccination without screening were evaluated. The most cost effective screening strategy proved to be that of sequential testing for anti-HBc, anti-HBs and finally HBsAg and vaccination of the following subjects: those who were negative for anti-HBc, those who were anti-HBc-positive with anti-HBs titers 10 less than mIU and those who were HBsAg negative.
D003362:Cost-Benefit Analysis; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006511:Hepatitis B Antigens / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D007159:Immunologic Tests / Q000191:economics; D007558:Italy; D010564:Personnel, Hospital; D014611:Vaccination / Q000191:economics
D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens