title: Hepatitis B screening: who to target? A French sexually transmitted infection clinic experience.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) infection is a major public health burden in France and worldwide. Routine screening for hepatitis B is not currently recommended in France. Medical experts and public health agencies opinions can differ concerning targeting criteria. Our study aims at developing a risk assessment strategy for identifying possible hepatitis B cases among the patients consulting in a French Sexually Transmitted Infection (STI) clinic.
  
  
  METHODS
  6194 asymptomatic patients requesting an STI screening were also screened for hepatitis B infection. The association between hepatitis B surface antigen (HBsAg) positivity and/or total hepatitis B core antibody (anti-HBc) positivity and self-reported risk factors for hepatitis were analysed.
  
  
  RESULTS
  Only male gender, lack of employment, and birth, in medium or high endemic country, were independently associated with HBsAg positivity in multivariate analysis. Sexual behaviour or self-reported vaccination status is therefore not necessary to target high-risk populations. These three simple criteria could save 25% of unnecessary tests and 6-16% undiagnosed hepatitis B compared to usual targeting criteria.
  
  
  CONCLUSIONS
  To detect HBsAg carriers, only three simple targeting criteria, without taking into account the self-reported vaccination status or sexual behaviour, could improve screening efficiency and save unnecessary testing.
authors.affiliation: Sexually Transmitted Centre, Toulouse University Hospital, France. spenatto.n@chu-toulouse.fr
authors.forename: N
authors.initials: N
authors.lastname: Spenatto
authors.forename: S
authors.initials: S
authors.lastname: Boulinguez
authors.forename: M
authors.initials: M
authors.lastname: Mularczyk
authors.forename: L
authors.initials: L
authors.lastname: Molinier
authors.forename: C
authors.initials: C
authors.lastname: Bureau
authors.forename: K
authors.initials: K
authors.lastname: Saune
authors.forename: R
authors.initials: R
authors.lastname: Viraben
mesh_terms: D000328:Adult; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology; D019353:Endemic Diseases; D005260:Female; D005602:France / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D010044:Outpatient Clinics, Hospital; D012307:Risk Factors; D012309:Risk-Taking; D014478:Unemployment; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens