— Christine M. Kukka, Project Manager, HBV Advocate
A study by the U.S. Centers for Disease Control and Prevention finds
undisputedly that it is cost effective to screen HBV-infected pregnant
women for HBeAg and HBV DNA to determine if antiviral treatment is
needed during pregnancy to tamp down viral load and prevent
mother-to-child (vertical) infection.
While immunization immediately after birth
reduces infection of newborns in more than 90% of cases, pregnant women
with high viral loads can still infect newborns despite immunization
and treatment with HBIG (HBV antibodies).
However, when women with high viral loads are
treated with antivirals during pregnancy, the risk of vertical
infection declines markedly and future infections and their associated
health care costs are avoided. But is this testing for high viral loads
cost effective?
Researchers analyzed the cost benefits of
screening HBV-infected women for either HBeAg and viral loads (both
reveal high viral loads) against continuing with the current policy of
just treating newborns.
The benefits were measured in quality-adjusted life-years (QALYs) and all costs were in 2010 U.S. dollars
"The HBeAg testing strategy saved $3.3 million
and 3,080 QALYs and prevented 486 chronic HBV infections compared with
the current recommendation," researchers wrote in the May issue of the
journal of Obstetrics and Gynecology.
"Testing HBsAg-positive pregnant women for HBeAg
or HBV load followed by maternal antiviral prophylaxis if
HBeAg-positive or high viral load to reduce (vertical) hepatitis B
transmission in the United States is cost-effective," they concluded.
Source: www.ncbi.nlm.nih.gov/pubmed/24785842
HBV Journal Review — June 1, 2014, Vol 11, no 6
Labels: pregnancy, screening
