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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/118792
Economic evaluations of HBV testing and treatment strategies and applicability to low and middle-income countries
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BACKGROUND: Many people living with chronic HBV infection remain
undiagnosed until later stages of disease. Increasing testing
and treatment rates form part of the strategy to respond to the
WHO goal of eliminating viral hepatitis as a public health
threat by 2030. However, achieving these ambitious targets is
dependent on finding effective and cost-effective methods of
scale up strategies. The aim of this study was to undertake a
narrative review of the literature on economic evaluations of
testing and treatment for HBV infection, to help inform the
development of the 2017 WHO Hepatitis Testing Guidelines.
METHODS: We undertook a focussed literature review for economic
evaluations on testing for HBV accompanied by antiviral
treatment. The search was carried out in Pubmed and included
only articles published after 2000 and written in English. We
narratively synthesise the results and discuss the key drivers
of cost-effectiveness and their applicability to low and
middle-income countries (LMICs). RESULTS: Nine published studies
were included in this review, only one of which was performed in
a low or middle-income setting in West Africa. Eight studies
were performed in high-income settings, seven among high risk
groups and one among the general population. The studies were
heterogeneous in many respects including the population and
testing strategy under consideration, model structure and
baselines parameters, willingness to pay thresholds and outcome
measures used. However, most studies found HBV testing and
treatment to be cost-effective, even at low HBsAg prevalence
levels. CONCLUSIONS: Currently economic evaluations of HBV
testing and treatment strategies in LMICs is lacking, therefore
limiting the ability to provide formal recommendations on the
basis of cost-effectiveness alone. Further implementation
research is needed in order to help guide national policy
planning.
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NAYAGAM, Shevanthi, et al. Economic evaluations of HBV testing and treatment strategies and
applicability to low and middle-income countries. BMC Infectious Diseases. 2017. Vol. 17, num. Suppl 1, pags. 692. ISSN 1471-2334. [consulted: 12 of October of 2026]. Available at: https://hdl.handle.net/2445/118792