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Is universal screening for hepatitis B infection warranted in all prenatal populations?

The purpose of this prospective study was to determine the prevalence of asymptomatic hepatitis B infection in a low-risk, closely monitored population. At the time of their first prenatal evaluation, a cohort of active-duty military personnel and their dependents underwent screening for hepatitis B surface antigen. Ten of 1520 women (0.66%) tested positive. All of these women were Asians and would have been identified under a selective screening protocol. None of the ten seropositive patients had other risk factors for hepatitis B infection. We conclude that in this type of population, universal screening for hepatitis B is not cost-effective. Selective screening for high-risk patients would appear to be more appropriate.