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Table 1 General assumptions of the Markov model of HCC prevention

From: Using a population-based approach to prevent hepatocellular cancer in New South Wales, Australia: effects on health services utilisation

Assumption How they were addressed and rationale
Recruitment of B Positive participants Target population age ≥ 35, HBsAg + ve for ≥ 6 months, born in China, Hong Kong, Vietnam
Contact testing and immunisation Not factored into the model
Seroprevalence data in target populations Data provided by Nguyen et al [19]
     • 10.7% for people born in China
     • 10.5% for people born in Vietnam
     • 7.7% for people born in Hong Kong
Initial testing to confirm CHB Not factored in GP consultation calculations
Program participation rates Base case assumption is 25% of eligible people enrolled
Follow up requirements    • Routine surveillance arm: 2 GP appointments/year
     • Enhanced HCC surveillance arm: 2 GP appointments/year
     • Interferon treatment: 6 specialist appointments/year
     • Entecavir treatment (includes those with liver failure): 4 specialist appointments/year
     • Patients with HCC: assumed monthly follow up
Viral load distribution by age Based upon REVEAL study, [22] as participant profile largely matches that of B Positive participants
ALT cut-off levels ALT≥ 1.5 × ULN triggers further evaluation in the absence of clinical data; ULN differentiated by participant age
Progression rates through disease stages Constant over time
Patients with high VL and abnormal liver function 30% receive first line interferon for 12 months
     • 30% seroconvert and receive no further treatment
     • 70% commence entecavir the following year
  70% receive entecavir as first-line treatment
     • 20% seroconvert in the first year of entecavir treatment and receive no further treatment
     • 80% continue lifelong entecavir
Patients with liver failure All receive entecavir
  1. VL: viral load
  2. ALT: alanine aminotransferase
  3. HBsAg: hepatitis B surface antigen