{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:33:09Z","timestamp":1769524389909,"version":"3.49.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>In an era of antiviral treatment, reexamination of the cost\u2010effectiveness of strategies to prevent perinatal hepatitis B virus (HBV) transmission in the United States is needed. We used a decision tree and Markov model to estimate the cost\u2010effectiveness of the current U.S. strategy and two alternatives: (1) Universal hepatitis B vaccination (HepB) strategy: No pregnant women are screened for hepatitis B surface antigen (HBsAg). All infants receive HepB before hospital discharge; no infants receive hepatitis B immunoglobulin (HBIG). (2) Current strategy: All pregnant women are screened for HBsAg. Infants of HBsAg\u2010positive women receive HepB and HBIG \u226412 hours of birth. All other infants receive HepB before hospital discharge. (3) Antiviral prophylaxis strategy: All pregnant women are screened for HBsAg. HBsAg\u2010positive women have HBV\u2010DNA load measured. Antiviral prophylaxis is offered for 4 months starting in the third trimester to women with DNA load \u226510<jats:sup>6<\/jats:sup> copies\/mL. HepB and HBIG are administered at birth to infants of HBsAg\u2010positive women, and HepB is administered before hospital discharge to infants of HBsAg\u2010negative women. Effects were measured in quality\u2010adjusted life years (QALYs) and incremental cost\u2010effectiveness ratios (ICER). Compared to the universal HepB strategy, the current strategy prevented 1,006 chronic HBV infections and saved 13,600 QALYs (ICER: $6,957\/QALY saved). Antiviral prophylaxis dominated the current strategy, preventing an additional 489 chronic infections, and saving 800 QALYs and $2.8 million. The results remained robust over a wide range of assumptions. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> The current U.S. strategy for preventing perinatal HBV remains cost\u2010effective compared to the universal HepB strategy. An antiviral prophylaxis strategy was cost saving compared to the current strategy and should be considered to continue to decrease the burden of perinatal hepatitis B in the United States. 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Control and Prevention,Atlanta,GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah F.","family":"Schillie","sequence":"additional","affiliation":[{"name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention,Centers for Disease Control and Prevention,Atlanta,GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trudy V.","family":"Murphy","sequence":"additional","affiliation":[{"name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention,Centers for Disease Control and Prevention,Atlanta,GA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2015,12,23]]},"reference":[{"key":"hep28310-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1086\/653622","article-title":"The prevalence of hepatitis B virus infection in the United States in the era of vaccination","volume":"202","year":"2010","journal-title":"J Infect 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