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Learning Objectives for this Presentation:
To evaluate the cost effectiveness of determining the prevalence of immunity of Hepatitis A and B, and Hepatitis C infection, prior to Hepatitis A and B immunization.
Background:
The CDC currently recommends Hepatitis B vaccination to all STD clinic clients who have not been previously immunized and Hepatitis A vaccines to select high risk groups. Prevalence of Hepatitis A and B immunity is essential in determining the cost effectiveness of screening prior to immunization.
Methods:
From February to March 2001, a convenience sample was done to determine the seroprevalence rates of antibodies to Hepatitis A, B and C. This was done in consecutive patients having routine syphilis serology with a target of 500 patients (200 females).
Results:
Of 513 clients tested for Hepatitis A (201 females, 312 males), 92 (18 %) were immune to Hepatitis A [31 (15.4%) females and 61 (19.5%) males]. Of 547 clients tested for Hepatitis B (217 females, 330 males), 126 (23%) were immune to hepatitis B [51 (23.5%) females, 75 (22.7 %) males]. Of 515 clients tested for Hepatitis C (201 females, 314 males), 38 (7.4 %) were positive for Hepatitis C [14(7.0 %) females and 24 (7.6%) males].
Conclusions:
Based on the low prevalence of Hepatitis A and B antibodies and the high laboratory, labor and other incidental costs involved in testing for hepatitis, it was determined that screening was NOT cost effective for Hepatitis A and B prior to vaccination in our STD Clinic. Hepatitis B vaccination was implemented in the Washington, DC STD Clinic in November 2001 without serologic screening and Hepatitis A vaccinations were added in May 2004.
Implications for Programs, Policy and Research:Prevalence data suggests that screening for Hepatitis A and B is not cost effective prior to vaccination in an urban STD Clinic setting.
See more of A5 - Hepatitis Vaccines: Making It a Reality in STD Clinics
See more of The 2005 National Viral Hepatitis Prevention Conference