Hepatitis B seroprevalence in the U.S. military and its impact on potential screening strategies
Year: 2020
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Knowledge of the contemporary epidemiology of hepatitis B virus (HBV) infection among military personnel can inform potential Department of Defense (DoD) screening policy and infection and disease control strategies. MATERIALS AND METHODS: HBV infection status at accession and following deployment was determined by evaluating reposed serum from 10,000 service members recently deployed to combat operations in Iraq and Afghanistan in the period from 2007 to 2010. A cost model was developed from the perspective of the Department of Defense for a program to integrate HBV infection screening of applicants for military service into the existing screening program of screening new accessions for vaccine-preventable infections. RESULTS: The prevalence of chronic HBV infection at accession was 2.3/1,000 (95% CI: 1.4, 3.2); most cases (16/21, 76%) identified after deployment were present at accession. There were 110 military service-related HBV infections identified. Screening accessions who are identified as HBV susceptible with HBV surface antigen followed by HBV surface antigen neutralization for confirmation offered no cost advantage over not screening and resulted in a net annual increase in cost of $5.78 million. However, screening would exclude as many as 514 HBV cases each year from accession. CONCLUSIONS: Screening for HBV infection at service entry would potentially reduce chronic HBV infection in the force, decrease the threat of transfusion-transmitted HBV infection in the battlefield blood supply, and lead to earlier diagnosis and linkage to care; however, applicant screening is not cost saving. Service-related incident infections indicate a durable threat, the need for improved laboratory-based surveillance tools, and mandate review of immunization policy and practice.
Source: Military Medicine
Authors: Paul T Scott, Robert L Cohen, David M Brett-Major, Shilpa Hakre, Jennifer A Malia, Jason F Okulicz, Charmagne G Beckett, Jason M Blaylock, Michael A Forgione, Stephen A Harrison, Clinton K Murray, Francisco J Rentas, Roland L Fahie, Adam W Armstrong, Aatif M Hayat, Laura A Pacha, Peter Dawson, Beth Blackwell, Angelia A Eick-Cost, Hala H Maktabi, Nelson L Michael, Linda L Jagodzinski, Steven B Cersovsky, Sheila A Peel
Institutions: Walter Reed Army Institute of Research, United States Agency for International Development, Defense Center for Public Health - Aberdeen, University of Nebraska Medical Center, Henry M. Jackson Foundation, Brooke Army Medical Center, Walter Reed National Military Medical Center, Naval Medical Research Command, Emmes (United States), Defense Health Agency, Cherokee Nation, Armed Forces Health Surveillance Center
Language: English
Topic: Hepatitis B Virus Studies
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,748
Award: G6063997168
OpenAlex ID: W3041352998