Sexually Transmitted Centre, Hôpital La Grave (Toulouse University Hospital), Place Lange, 31 059 Toulouse (France). Electronic address: firstname.lastname@example.org.
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.
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.
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.
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.