PMID- 36221140 OWN - NLM STAT- MEDLINE DCOM- 20221013 LR - 20221015 IS - 2049-9957 (Electronic) IS - 2095-5162 (Print) IS - 2049-9957 (Linking) VI - 11 IP - 1 DP - 2022 Oct 11 TI - Impact of the national hepatitis B immunization program in China: a modeling study. PG - 106 LID - 10.1186/s40249-022-01032-5 [doi] LID - 106 AB - BACKGROUND: Elimination of hepatitis B virus (HBV) is a striking challenge for countries with high or moderate disease burden. Therefore, using China as a practical case to share experiences for similar countries may accelerate the achievement of the WHO 2030 target of 90% reduction in HBV-related incidence. We aim to evaluate the impact of national HBV immunization strategies in China; and the feasibility to achieve WHO 2030 targets under different scenarios. METHODS: We constructed an expanded Susceptible-Exposed-Infectious-Recovered (SEIR) model and decision tree-Markov model to estimate the epidemic of HBV in China, assess the feasibility of 2030 Elimination Goals through the projections and conduct the economic analysis. Least square method was used to calibrate the expanded SEIR model by yearly data of laboratory-confirmed HBV cases from 1990 to 2018. Two models were separately used to evaluate the impact and cost-effectiveness of HBV vaccine by comparing prevalence of chronic HBV infections, quality-adjusted life-years (QALYs), incremental cost effectiveness ratio and benefit-cost ratio (BCR) under various intervention options, providing a basis for exploring new containment strategies. RESULTS: Between 1990 and 2020, the number of chronic HBV infections decreased by 33.9%. The current status quo would lead to 55.73 million infections (3.95% prevalence) in 2030, compared to 90.63 million (6.42% prevalence) of the "Without the NIP" scenario (NIP: National Immunization Program), 114.78 million (8.13% prevalence) without any interventions. The prevention of mother to child transmission (PMTCT) strategy showed a net benefit as 12,283.50 dollars per person, with BCR as 12.66, which is higher than that of universal vaccination at 9.49. Compared with no screening and no vaccination, the PMTCT strategy could save 7726.03 dollars for each QALY increase. CONCLUSIONS: Our findings proved the HBV vaccination has demonstrated a substantial positive impact on controlling the epidemic of HBV in terms of effectiveness and economy after about 30 years of implementation of the national hepatitis B immunization program which also provided containment experience for high or medium burden countries. As for China, the next step should focus on exploring strategies to improve diagnosis and treatment coverage to reduce the burden of HBV-related deaths and ultimately eliminate HBV. CI - (c) 2022. The Author(s). FAU - Liu, Zhixi AU - Liu Z AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. FAU - Li, Mengying AU - Li M AD - Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China. FAU - Hutton, David W AU - Hutton DW AD - School of Public Health, University of Michigan, Ann Arbor, MI, USA. FAU - Wagner, Abram L AU - Wagner AL AD - School of Public Health, University of Michigan, Ann Arbor, MI, USA. FAU - Yao, Ye AU - Yao Y AD - Department of Biostatics, School of Public Health, Fudan University, Shanghai, 200032, China. FAU - Zhu, Wenlong AU - Zhu W AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. FAU - Cao, Lingsheng AU - Cao L AD - Chinese Center for Disease Control and Prevention, National Immunization Program, Beijing, China. FAU - Tang, Shenglan AU - Tang S AD - Duke Global Health Institute, Duke University, Durham, NC, USA. FAU - Pan, Jinhua AU - Pan J AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. FAU - Wang, Yesheng AU - Wang Y AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. FAU - Zhao, Qi AU - Zhao Q AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. FAU - Ren, Hong AU - Ren H AD - Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China. FAU - Wang, Ying AU - Wang Y AD - Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China. wangying1013@fudan.edu.cn. FAU - Wang, Weibing AU - Wang W AUID- ORCID: 0000-0002-4497-5251 AD - School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China. wwb@fudan.edu.cn. LA - eng GR - GWV-10.1-XK16/Shanghai New Three-year Action Plan for Public Health/ PT - Journal Article DEP - 20221011 PL - England TA - Infect Dis Poverty JT - Infectious diseases of poverty JID - 101606645 RN - 0 (Hepatitis B Vaccines) SB - IM MH - China/epidemiology MH - Cost-Benefit Analysis MH - Female MH - *Hepatitis B/epidemiology/prevention & control/transmission MH - *Hepatitis B Vaccines/administration & dosage MH - Hepatitis B, Chronic/epidemiology/prevention & control MH - Humans MH - *Immunization Programs MH - Infant, Newborn MH - Infectious Disease Transmission, Vertical/prevention & control MH - Pregnancy MH - Program Evaluation PMC - PMC9552421 OTO - NOTNLM OT - Economic analysis OT - Hepatitis B OT - National immunization program OT - Prevalence OT - Susceptible-Exposed-Infectious-Recovered modeling COIS- All authors have declared: no support from any organizations for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. EDAT- 2022/10/12 06:00 MHDA- 2022/10/14 06:00 PMCR- 2022/10/11 CRDT- 2022/10/11 23:41 PHST- 2022/06/15 00:00 [received] PHST- 2022/09/21 00:00 [accepted] PHST- 2022/10/11 23:41 [entrez] PHST- 2022/10/12 06:00 [pubmed] PHST- 2022/10/14 06:00 [medline] PHST- 2022/10/11 00:00 [pmc-release] AID - 10.1186/s40249-022-01032-5 [pii] AID - 1032 [pii] AID - 10.1186/s40249-022-01032-5 [doi] PST - epublish SO - Infect Dis Poverty. 2022 Oct 11;11(1):106. doi: 10.1186/s40249-022-01032-5.