Cost-Effective Perinatal HBV Transmission Prevention ID'ed

Lamivudine, hepatitis B immune globulin prevent hepatitis B virus transmission cost-effectively

WEDNESDAY, Aug. 31 (HealthDay News) -- In hepatitis B surface-antigen-positive pregnant women, administration of lamivudine or hepatitis B immune globulin (HBIG) in the third trimester is a cost-effective method for prevention of perinatal transmission of hepatitis B, according to a study published in the September issue of Obstetrics and Gynecology.

Elizabeth Ramsey Unal, M.D., from the Medical University of South Carolina in Charleston, and colleagues estimated and compared the cost-effectiveness of maternal administration of either lamivudine or HBIG treatment in the third trimester, for the prevention of perinatal hepatitis B virus transmission versus no maternal treatment. A decision tree model was created, and was first estimated for each treatment using overall transmission rates, and then by stratifying according to maternal hepatitis B virus DNA viral load.

The investigators estimated that for each 100 hepatitis B surface antigen-positive pregnant women, 9.7 and 9.5 cases of chronic hepatitis B virus infection were prevented for those treated with lamivudine and HBIG, respectively. This resulted in cost savings of $5,184 and $5,887, and a gain of 1.3 and 1.2 life-years per patient treated with lamivudine and HBIG, respectively. Under baseline assumptions, lamivudine and HBIG remain cost-effective unless the reduction in perinatal transmission is less than 18.5 and 9.6 percent, respectively.

"In this decision analysis, administration of lamivudine or HBIG to hepatitis B surface antigen-positive pregnant women for the prevention of perinatal transmission of hepatitis B is cost-saving across a wide range of assumptions," the authors write.

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