Community-based research: cost of the tests used for anti-HBc total seropositivity only and hepatitis B screening

Our study aimed to determine anti-HBc total (IgG+IgM) seroprevalence in the adult population aged ≥15 and to compare the cost of testing for HBsAg and anti-HBs in only anti-HBc positive (+) subpopulation to that in the whole population for HBV screening. The study involved a face-to-face survey and peripheral blood sampling from 452 adult subjects for HBV tests. HBV-DNA PCR was studied only in anti-HBc(+)subjects. Of the 452 subjects anti-HBc total was positive in 192 (42.47%), of which: (a) 27 (14.06%) were HBsAg(+), anti-HBs negative (-), (b) 126 (65.62%) were HBsAg(-), anti-HBs(+), (c) 39 were HBsAg(-), anti-HBs(-). This last group (c) were tested for HBV-DNA PCR and six (15.38%) were positive. When we perform HBsAg and anti-HBs tests in all 452 subjects as in routine practice in blood banks, the cost is 3320 Euros. However, when all subjects are tested for anti-HBc total at first and then only anti-HBc total(+) ones are tested for HBsAg and anti-HBs, the cost is 2929 Euros. The cost difference between the two methods is 391 Euros for 452 subjects. Accordingly, our HBV screening algorithm brings a financial saving of 11.78% and helps to identify the isolated anti-HBc total(+) subjects who carry potential risk for spreading HBV.