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Ante-natal screening for hepatitis B surface antigen: an appraisal of its value in a low prevalence area

Published online by Cambridge University Press:  15 May 2009

M. J. Dwyer  and
P. G. McIntyre
M. J. Dwyer
Affiliation:
Anglia and Oxford Regional Health Authority
P. G. McIntyre*
Affiliation:
Clinical Microbiology and Public Health Laboratory, Cambridge
*
* Dr P. G. McIntyre, Department of Medical Microbiology, Level 6, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
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The costs and projected benefits of universal screening for hepatitis B virus (HBV) infection in pregnant women in East Anglia are calculated and compared with current practice. By adjusting data from West Midlands region for ethnicity, the prevalence of maternal hepatitis B surface-antigen (HBsAg) positivity in East Anglia is predicted to be 0·083% (1 in 1200). Published data on health risks of perinatal HBV infection and on immunisation efficacy are used to derive benefits of screening. The marginal direct cost of screening is identified from regional sources. Current clinical practice in East Anglia identifies 7 surface-antigen positive mothers per year, whereas 22 are expected. Routine antenatal screening in East Anglia would prevent 2·6 additional childhood carriers per year (compared with current practice), resulting in the prevention of 0·7 deaths per year occuring 40–50 years in the future. The direct cost per (undiscounted) life-year saved would be £2437, not including savings on treatment for chronic hepatitis B infection. Routine prenatal screening for maternal HBsAg should be introduced without delay and continue even if HBV vaccination is introduced into the UK childhood immunisation schedule.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 1 , August 1996 , pp. 121 - 131
Copyright
Copyright © Cambridge University Press 1996

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