Cost effectiveness of screening for only anti-HBc in institutions for mentally retarded persons

During the screening and vaccination program for hepatitis B in state institutions for mentally retarded individuals, 7,273 staff and clients were screened. Of these, 1,561 persons (21.5%) had at least one marker. Of this number, 95.5% (N = 1,491) were positive for anti-HBc, and 77.8% (N = 1,214), for anti-HBs. Screening prior to vaccination, at a cost per person of $100, was cost effective when both anti-HBc and anti-HBs tests were performed on every individual; however, anti-HBc alone is the test of choice for a large-scale screening and vaccination program and is even more cost effective.