Source
Sexually Transmitted Centre, Hôpital La Grave (Toulouse University Hospital), Place Lange, 31 059 Toulouse (France). Electronic address: spenatto.n@chu-toulouse.fr.
Abstract
BACKGROUND:
Hepatitis B virus (HBV) infection is a major public health burden in France and worldwide. Routine screening for hepatitis B is not currently recommended in France. Medical experts and public health agencies opinions can differ concerning targeting criteria. Our study aims to develop a risk assessment strategy for identifying possible hepatitis B cases among the patients consulting in a French Sexually Transmitted Infection (STI) clinic.
METHODS:
6194 asymptomatic patients requesting a STI screening were also screened for hepatitis B infection. The association between hepatitis B surface antigen (HBsAg) positivity and/or total hepatitis B core antibody (anti-HBc) positivity and self-reported risk factors for hepatitis were analysed.
RESULTS:
Only male gender, lack of employment, and birth in medium or high endemic country were independently associated with HBsAg positivity in multivariate analysis. Sexual behaviour or self-reported vaccination status are therefore not necessary to target high-risk populations. These three simple criteria could save 25% of unnecessary tests and 6 to 16% undiagnosed hepatitis B compared to usual targeting criteria.
CONCLUSIONS:
To detect HBsAg carriers, only simple three targeting criteria, without taking into account the self-reported vaccination status or sexual behaviour, could improve screening efficiency and save unnecessary testing.