Evidence map›Paper›PMID 40198094›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

Cost-Effectiveness of One-time Universal Testing for Hepatitis D Among Adults With Chronic Hepatitis B in the United States.

Mehlika Toy, David Hutton, Eyasu Teshale, William W Thompson, Hang Pham, Joshua A Salomon, Samuel So

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Mehlika ToyErasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
David HuttonDepartment of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0001-9677-1632
Eyasu TeshaleDivision of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
William W ThompsonDivision of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-8293-9641
Hang PhamAsian Liver Center, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Joshua A SalomonDepartment of Health Policy, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0003-3929-5515
Samuel SoAsian Liver Center, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.

Funding

CDC HHSNational Center for HIV, Viral Hepatitis, STD, and TB Prevention NU38PS004651
6 · The paper itself

Abstract

backgroundChronic hepatitis D virus (HDV) infection increases the risk of liver-related deaths in adults with chronic hepatitis B (CHB). In the United States (US), only an estimated 12.9% of adults with CHB have received an HDV antibody test. The aim of this study is to calculate the cost-effectiveness of one-time universal HDV testing of hepatitis B surface antigen (HBsAg)-positive adults living in the US.

methodsA Markov model was used to calculate the costs, health impact, and cost-effectiveness of universal testing of HBsAg-positive adults with an HDV antibody test and, when positive, an HDV RNA test for chronic HDV infection. We assumed that 50% of the HDV RNA-positive patients would receive the current recommended treatment with pegylated interferon (PEG-IFN) for 48 weeks with a 30% response rate. We also modeled the potential impact of hypothetical indefinite HDV antiviral therapy with a higher response rate to assess the annual cost threshold to be considered cost-effective.

resultsUniversal HDV testing of adults with CHB could avert 100 HDV-related deaths and an additional 30 cases of cirrhosis and 50 cases of hepatocellular carcinoma, and potentially result in a gain of 1500 quality-adjusted life-years (QALYs) per 100 000 HBsAg-positive individuals screened. At a willingness-to-pay threshold of $50 000 per QALY, the annual drug costs for a hypothetical indefinite therapy with a 50% or 70% treatment response rate would need to cost ≤$13 027 and ≤$14 104, respectively.

conclusionsOne-time HDV testing for all HBsAg-positive adults and treatment of chronic HDV infection with PEG-IFN is potentially cost-effective in the US.

Indexed as

Hepatitis B, ChronicHepatitis D, ChronicAdultAntiviral AgentsCost-Benefit AnalysisFemaleHepatitis B Surface AntigensHepatitis Delta VirusHumansMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsRNA, ViralUnited StatesAntiviral AgentsHepatitis B Surface AntigensRNA, Viralcost-effectivenessdelta hepatitisHDVscreeningviral hepatitis

Identifiers

PMID40198094
PMCPMC12598672

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.