Hepatitis B seroprevalence in the U.S. military and its impact on potential screening strategies

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. MaktabiNelson L. Michael, Linda L. Jagodzinski, Steven B. Cersovsky, Sheila A. Peel

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)E1654-E1661
JournalMilitary medicine
Volume185
Issue number9-10
DOIs
StatePublished - Sep 1 2020

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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