Navigation Links
Screening for hepatitis B may be cost-effective for more of the population, analysis shows
Date:5/3/2011

CINCINNATIHepatitis B virus (HBV) continues to be a major health issue in the United States despite prevention strategies.

Now, research at the University of Cincinnati (UC) provides evidence that current prevention and screening standards are worth the cost and may even need expansion to include more of the population, further helping prevent the spread of this life-threatening disease.

The findings are published in the May 3, 2011 advance online edition of the journal Clinical Infectious Diseases.

Mark Eckman, MD, UC Health physician and professor of medicine, and co-investigators Tiffany Kaiser, PharmD, research assistant professor of medicine, and Kenneth Sherman, MD, PhD, director of the UC digestive diseases division, found that the U.S. Centers for Disease Control and Prevention's guideline to screen populations with a prevalence of more than 2 percent is cost-effective.

"Furthermore, screening of adults in the United States in lower-prevalence populations is also likely to be cost-effective, which could mean that current health policy should be reconsidered," says Eckman.

HBV causes liver injury. The infection can be spread through contact with the blood, semen, vaginal fluids and other body fluids of someone who already has an HBV infection.

Most of the damage from the virus occurs because of the way the body responds to the infection. When the body's immune system detects the infection, it sends out cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.

"The recent Institute of Medicine report on hepatitis and liver cancer notes that up to 2 million Americans are chronically infected with HBV, although 75 percent of people or more may not know their status and are diagnosed with the disease late; chronic HBV infection leads to cirrhosis, liver failure or liver cancer," Eckman and colleagues say. "While previous analyses have focused on prevention, the cost-effectiveness of treatment strategies and/or screening and vaccinating high-risk populations, none have evaluated the larger question of screening and treatment in the general adult population.

"In this analysis, we wanted to assess the cost-effectiveness of screening in populations with varying prevalence of HBV infection to see if current protocol was beneficial."

Eckman, Kaiser, and Sherman developed a Markov state transition decision modela mathematical framework for modeling decision-making in situations where outcomes are partly due to chance and partly under the control of a decision maker. They used this to examine screening of outpatients with hepatitis B in the U.S. who are not experiencing symptoms.

"We used a standard computer program to build the model, analyze results and perform sensitivity analyses," Eckman says. "Our base case involved a hypothetical 35-year-old man living in a region with an HBV infection prevalence of 2 percent."

Researchers compared no screening for HBV to screening followed by treatment with one of four therapies: pegylated interferon-alpha 2a or a low-cost nucleoside or nucleotide agent with a high rate of developing viral resistance, both taken for 48 weeks, and a low-cost, high-resistance nucleoside or a high-cost nucleoside or nucleotide with a low rate of developing viral resistance, both taken for prolonged periods.

"Effectiveness was measured in quality-adjusted life years and costs in U.S. dollars for 2008," Eckman says.

Results showed that screening followed by treatment with a low-cost, high-resistance nucleoside or nucleotide was cost-effective at $29,000 per quality-adjusted life year gained.

Due to controversy surrounding the use of high-resistance agents, researchers also analyzed the cost-effectiveness of screening followed by treatment with a low-resistance agent and found that this strategy was also cost-effective, at roughly $44,000 per quality-adjusted life year gained compared with no screening.

"Current guidelines, such as those of the U.S. Preventive Services Task Force, do not recommend universal screening for HBV infection in the general population and utilize relatively high rates of prevalence in targeted populations," Eckman says. "Our analysis suggests that screening becomes cost-effective at a population prevalence as low as 0.3 percent1.7 percent lower than current guidelineswith a cost at $50,000 per quality-adjusted life years gained."

Eckman adds that the best practice for patients must also account for patient-to-patient variability in preferences for health outcomes and treatment side effects, as well as other factors like racial differences in the risk of liver cancer in HBV.

"While the most cost-effective treatment strategy for those found to be infected with HBV may evolve in the future, given newer and more effective agents or more complex therapies for patients who develop resistance, screening for chronic HBV infection is likely to be cost-effective, even in low-prevalence populations," he says. "These findings suggest that current health policy with regard to screening should be reconsidered, which could detect this life-threatening illness earlier, potentially saving more lives."


'/>"/>

Contact: Katie Pence
katie.pence@uc.edu
513-558-4561
University of Cincinnati Academic Health Center
Source:Eurekalert

Related medicine news :

1. Quick Screening May Help Spot Autism in Babies
2. A screening test for cognitive therapy?
3. Innovative screening method identifies possible new treatment for fatal childhood disease
4. Prostate Cancer Screening Doesnt Cut Death Rates: Study
5. In vivo RNAi screening identifies new regulators of liver regeneration
6. Researchers find many elderly men are undergoing unnecessary PSA screenings
7. Do all student athletes need heart screenings?
8. Screening Seems to Catch Dangerous Heart Condition in Kids
9. Newborn Screenings May Miss Hearing Loss in Some Kids
10. In pilot study, screening detects potentially serious heart conditions in healthy children
11. Universal screening programs can uncover abuse, study finds
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... June 19, ... the dangers associated with chronic pain and the benefits of holistic treatments, Serenity ... who are suffering with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, ... Elite. The attorneys chosen by their peers for this recognition are considered among the ... Traurig Shareholders received special honors as members of this year’s Legal Elite Hall of ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway ... call for a minimum wage raise to $12 an hour by 2020 and then adjusting ... restore the lost value of the minimum wage, assure the wage floor does not erode ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm Slone ... executive with extensive sequencing and genomics experience, as Vice President of North American Capital ... will be responsible for leading the sales team in the commercialization of the HTG ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the ... report to their offering. ... favourable commercial environment for MedImmune to enter. The US ageing ... serve to drive considerable growth for effective anti-influenza medications. The ... sales considerably, but development is still in its infancy. ...
(Date:6/23/2016)... RIDGE, Ill. and INDIANAPOLIS ... of students receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship ... The 2016 scholarship winners, announced today online at ... to let type 1 diabetes stand in the way ... Diabetes has supported the Foundation,s scholarship program since 2012, ...
(Date:6/23/2016)... N.J. , June 23, 2016  Guerbet announced ... Premier Inc.,s Supplier Horizon Award . ... year, Guerbet was recognized for its support of Premier ... creation through clinical excellence, and commitment to lower costs. ... to receive this recognition of our outstanding customer service ...
Breaking Medicine Technology: