{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:04:29Z","timestamp":1792173869561,"version":"4.4.0"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"the Centers for Disease Control and Prevention National Center for HIV\/AIDS, Viral Hepatitis, STD,"},{"name":"TB Prevention Epidemiologic and Economic Modeling","award":["NU38PS004651"],"award-info":[{"award-number":["NU38PS004651"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An estimated 862 000 to 2.4 million people have chronic hepatitis B infection (CHB). Hepatitis B screening is recommended for pregnant women and populations with increased CHB risk. However, diagnosis rates remain low, with only 33% of people with CHB aware of their infection. This study aimed to assess the cost-effectiveness of universal adult screening for CHB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a Markov model to calculate the costs, population health impact, and cost-effectiveness of 1-time universal screening and CHB monitoring and treatment compared with current practice. Sensitivity analysis was performed on model parameters to identify thresholds for cost-saving or cost-effectiveness based on a willingness to pay of $50 000\/quality-adjusted life-year. The analysis assumed testing would be performed during routine healthcare visits and that generic tenofovir or entecavir would be dispensed for treatment. Testing costs were based on Medicare reimbursement rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At an estimated 0.24% prevalence of undiagnosed CHB, universal hepatitis B surface antigen (HBsAg) screening in adults aged 18\u201369 years is cost-saving compared with current practice if antiviral treatment drug costs remain below $894\/year. Compared with current practice, universal screening would avert an additional 7.4 cases of compensated cirrhosis, 3.3 cases of decompensated cirrhosis, 5.5 cases of hepatocellular carcinoma, 1.9 liver transplants, and 10.3 hepatitis B virus\u2013related deaths at a saving of $263 000\/100 000 adults screened.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Universal HBsAg screening of adults in the US general population for CHB is cost-effective and likely cost-saving compared with current CHB screening recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab405","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T17:03:26Z","timestamp":1620147806000},"page":"210-217","source":"Crossref","is-referenced-by-count":67,"title":["Cost-Effectiveness of 1-Time Universal Screening for Chronic Hepatitis B Infection in Adults in the United States"],"prefix":"10.1093","volume":"74","author":[{"given":"Mehlika","family":"Toy","sequence":"first","affiliation":[{"name":"Asian Liver Center, Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hutton","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Michigan, Ann Harbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noele","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A","family":"Salomon","sequence":"additional","affiliation":[{"name":"Center for Health Policy\/Center for Primary Care and Outcomes Research, Stanford University, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"So","sequence":"additional","affiliation":[{"name":"Asian Liver Center, Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"2022012912315490700_CIT0001","article-title":"Board on Population Health and Public Health Practice; Health and Medicine Division;","volume-title":"Eliminating the public health problem of hepatitis B and C in the United States: phase one report","author":"Committee on a National Strategy for the Elimination of Hepatitis B and 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