Serological markers of Hepatitis B infection: a study to reduce cost and improve interpretation

ABSTRACT

Serological markers of hepatitis B infection are useful markers for the diagnosis and monitoring of infection, but complex interpretation and high cost limit their clinical usage in the developing world. The objective of the study was to develop simple and cost effective panels for the diagnosis of hepatitis B infection to improve its interpretation and reduce cost. All those persons who were serologically investigated for the diagnosis or exposure to Hepatitis B infection on a standard panel at the clinical laboratory of Liaquat National Hospital, Karachi during the period 1997-2002 and found reactive for any of these markers were included in the study. Six cost effective sub panels of different serological states of hepatitis B infection were developed and their efficiency and cost evaluated against the performance and cost of a standard panel of hepatitis B serological states. Out of 511 serological presentations of hepatitis B tests evaluated, 434[85%] presentations were easily interpretable on the standard panel and 475 [93%] on the proposed cost effective sub panels. Proposed sub panels reduced the cost ranging from 80% to 50% Appropriate and judicious selection of hepatitis B markers against the use of standard panel of 6 markers altogether can improve the interpretation of the test and reduce the cost effectively