An economic analysis of premarriage prevention of hepatitis B transmission in Iran.
BACKGROUND
To assess the economic aspects of HBV (hepatitis B virus) transmission prevention for premarriage individuals in a country with cultural backgrounds like Iran and intermediate endemicity of HBV infection.


METHODS
A cost-effectiveness analysis model was used from the health care system and society perspectives. The effectiveness was defined as the number of chronic HBV infections averted owing to one of the following strategies:1) HBsAg screening to find those would-be couples one of whom is HBsAg positive and putting seronegative subjects on a protection protocol comprising HBV vaccination, single dose HBIG and condom protection.2) HBsAg screening as above, in addition to performing HBcAb screening in the HBsAg negative spouses of the HBsAg positive persons and giving the protocol only to HBcAb negative ones.Sensitivity and threshold analyses were conducted.


RESULTS
The cost of each chronic infection averted was 202$ and 197$ for the strategies 1 and 2, respectively. Sensitivity analysis showed that strategy 2 was always slightly cheaper than strategy 1. The discounted threshold value for the lifetime costs of chronic liver disease, above which the model was cost saving was 2818$ in strategy 1 and 2747$ in strategy 2.


CONCLUSIONS
Though premarriage prevention of HBV transmission in the countries with cultural backgrounds similar to Iran seems cost saving, further studies determining precise costs of HBV infection in Iran can lead to a better analysis.
Adibi
Peyman
P
Research Center for Gastroenterology and Liver Disease, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. payad2000@yahoo.com
Rezailashkajani
Mohammadreza
M
Roshandel
Delnaz
D
Behrouz
Negar
N
Ansari
Shahin
S
Somi
Mohammad Hossein
MH
Shahraz
Saeed
S
Zali
Mohammad Reza
MR
D017280:Condoms / Q000191:economics; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000191:economics; D006801:Humans; D007136:Immunoglobulins / Q000191:economics; D007492:Iran / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D011291:Premarital Examinations / Q000191:economics* / Q000379:methods; D015995:Prevalence; D012680:Sensitivity and Specificity
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin