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A Cost Comparison Analysis for Screening and Vaccination of Hospital Personnel with High- and Low-Prevalence Hepatitis B Virus Antibodies in California

Published online by Cambridge University Press:  09 April 2017

Myron J. Tong ,
Ruth L. Co ,
Robin D. Marci ,
Phyllis M. Michaelson  and
George Ortega
Myron J. Tong*
Affiliation:
The Liver Center, Huntington Memorial Hospital, Pasadena French Hospital, Los Angeles The Chinese Hospital
Ruth L. Co
Affiliation:
The Liver Center, Huntington Memorial Hospital, Pasadena French Hospital, Los Angeles The Chinese Hospital
Robin D. Marci
Affiliation:
The Liver Center, Huntington Memorial Hospital, Pasadena French Hospital, Los Angeles The Chinese Hospital
Phyllis M. Michaelson
Affiliation:
The Liver Center, Huntington Memorial Hospital, Pasadena French Hospital, Los Angeles The Chinese Hospital
George Ortega
Affiliation:
The Liver Center, Huntington Memorial Hospital, Pasadena French Hospital, Los Angeles The Chinese Hospital
*
Liver Center, Huntington Memorial Hospital, Pasadena, CA 91105
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Abstract

We compared the cost of antibody screening and the projected cost for hepatitis B vaccination of antibody-negative individuals at hospitals with “high prevalence” and “low prevalence” rates for hepatitis B virus antibodies among their employees. The use of hepatitis B core antibody for screening and subsequent hepatitis B vaccination of antibody-negative personnel was most cost-effective for hospitals considered to have high prevalence for hepatitis B virus antibodies among its staff, although use of hepatitis B surface antibody in this setting only increased costs by 1.4%. In a hospital with low prevalence for hepatitis B virus antibodies among its staff, use of hepatitis B surface antibody and subsequent vaccination of antibody-negative individuals was the most cost-effective approach, while use of hepatitis B core antibody for the above purposes would have increased costs by 3.4%. The use of both hepatitis B surface antibody and core antibody in either setting followed by immunization was least economical, as costs were increased by 13% and 13.5% respectively.

We concluded that hepatitis B core antibody should be used for screening in hospitals with high prevalence for hepatitis B virus antibodies among employees while hepatitis B surface antibody be used for screening in hospitals with low prevalence for hepatitis B virus antibodies among employees. A prediction of high and low prevalence for hepatitis B virus antibodies in hospital personnel may be made by knowledge of the distribution in ethnicity of staff.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 9 , Issue 2 , February 1988 , pp. 66 - 71
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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References

1.Recommendations for protection against viral hepatitis. MMWR 1985; 34:313–335.Google Scholar
2.Dienstag, JL, Ryan, DM: Occupational exposure to hepatitis B virus in hospital personnel: Infection or immunization? Am J Epidemiol 1982; 115:26–39.CrossRefGoogle ScholarPubMed
3.Lewis, TLTAlter, HJ, Chalmers, TC, et al: A comparison of the frequency of hepatitis B antigen and antibody in hospital and nonhospital personnel. N Engl J Med 1973: 289:647–651.Google Scholar
4.Hadler, SC, Doto, IL, Maynard, JE, et al: Occupational risk of hepatitis B infection in hospital workers. Infect Control 1985; 6:24–31.Google Scholar
5.Tong, MJ, Howard, AM, Schatz, GC, et al: Hepatitis B vaccine: Assessment of a demonstration project in a community teaching hospital. Infect Control 1987; 8:102–107.Google Scholar
6.Grady, GK: Hepatitis B immunity in hospital staff targeted for vaccination. Role of screening tests in immunization programs. JAMA 1982; 248:2266–2269.Google Scholar
7.Tong, MJ. Yu, M, Co, R, et al: Hepatitis B virus markers in the foreign-born Chinese population of Los Angeles, California. N infect Dis 1984; 149:475.Google Scholar
8.Hadler, SC, Murphy, BL, Schable, CA, et al: Epidemiologic analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens. J Clin Microbiol 1984; 19:521–525.Google Scholar
9.Szmuness, W, Stevens, CE. Ikram, H, et al: Prevalence of hepatitis B virus infection and hepatocellular carcinoma in Chinese-Americans. J Infect Dis 1978; 137:822–829.CrossRefGoogle ScholarPubMed
10.Chen, DS, Sung, JL: Hepatitis B virus infection and chronic liver disease in Taiwan. Acta Hepato Gastroenterol 1978; 25:423–430.Google Scholar
11.Lam, KC, Yu, MC. Leung, WC, et al: Hepatitis B virus and cigarette smoking: Risk factors for hepatocellular carcinoma in Hong Kong. Cancer Res 1982; 42:5246–5248.Google Scholar
12.Yeh, F-S, Mo, C-C, Luo, Si. et al: A serological case-control study of primary hepatocellular carcinoma in Guangxi, China. Cancer Res 1985; 45:872–873.Google ScholarPubMed
13.Basaca-Seville, V, Cross, JH, Pastrana, E: The hepatitis B problem in the Philippines. Southeast Asian J Trop Med Public Health 1986; 17:75–81.Google Scholar
14.Wang, S-S, Yeh, C-L, Tasai, Y-T, et al: Occupational exposure to hepatitis B virus among hospital personnel. J Formosan Med Assoc 1985; 84:816.Google ScholarPubMed
15.Stevens, CE, Toy, PT, Tong, MJ, et al: Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA 1985; 253:1740–1745.Google Scholar
16.Klimek, JJ, Brettman, L. Neuhaus, E, et al: A multi-hospital hepatitis B vaccine program: Prevalence of antibody and acceptance of vaccination among high-risk hospital employees. Infect Control 1985; 6:32–34.Google Scholar
17.Storch, GA, Perrillo, RP, Miller, JP, et al: Prevalence of hepatitis B antibodies in personnel at a children's hospital. Pediatrics 1985; 76:29–35.Google Scholar
18.Martin, DB. jannausch, M, Skendzel, LP: The prevalence of hepatitis B in employees of small, rural hospitals-Implications for vaccine administration. Infect Control 1986: 7:64–66.CrossRefGoogle ScholarPubMed
19.Harris, JR, Finger, RF, Kobayashi, JM, et al: The low risk of hepatitis B in rural hospitals. JAMA 1984; 252:3270–3272.Google Scholar
20.Hanson, M, Polesky, HF: Prevalence of anti-HBc in anti-HBs positive individuals: Implications for selecting vaccine candidates. Am J Clin Pathol 1984; 82:716–719.Google Scholar
21.Dienstag, JL, Stevens, CE. Bhan, AK, et al: Hepatitis B vaccine administered to chronic carriers of hepatitis B surface antigen. Ann Intern Med 1982; 96:575–579.CrossRefGoogle ScholarPubMed