Affiliations 

  • 1 Ministry of Health
  • 2 Hospital Selayang
  • 3 Ministry of Health Malaysia
MyJurnal

Abstract

Introduction: Universal HBV and HCV screening among pregnant women is not a current practice in Malaysia. It is aimed to conduct a systematic review on available evidences in an effort to strengthen the national hepatitis screen-ing programs. Methods: Systematic search was performed from databases; Medline, Cochrane, PubMed and IN-AHTA. Relevant studies according to inclusion/exclusion criteria were critically appraised and evidence graded. Re-sults: From 782 titles identified, two systematic reviews, two retrospective cohort studies, two cross-sectional studies, one cost-utility analysis and one cost-effectiveness analysis were included. Universal antenatal HBV screening was associated with almost complete vaccination coverage for newborns. Replacing targeted screening with universal HBV screening was associated with increased identification of newborns indicated for HBV-immunization from 50% to 96%. Universal antenatal HBV screening had incremental cost-effectiveness ratio (ICER)s ranged from €2,032 to €26,181 per life year (LY) gained. As for HCV, targeted antenatal screening was associated with low HCV prevalence. Universal screening did not detect significantly more women with HCV infection than did targeted screening. One cost-effectiveness analysis found that universal antenatal HCV screening had ICER of €52,473 per LY gained and one cost-utility analysis reported ICER of £9,139 per QALY gained. Conclusion: Based on the above review, universal HBV screening in pregnant women is effective in increasing vaccination coverage for newborns. However, the ICERs had wide range. Therefore, local economic evaluation is needed to estimate cost implications before considering addition into national screening program. While for HCV, both universal and targeted screening in pregnant women had low detection rate thus high-risk approach screening is appropriate in Malaysia.