Konijeti GG, Grandhe S, Konerman M, et al. - In a population of adults with solid tumors in the United States, researchers analyzed the cost-effectiveness of hepatitis B virus (HBV) screening before chemotherapy. Three HBV screening strategies (screen all, the screen only high-risk patients, or screen none) were compared using a Markov model of a population of adults who started chemotherapy for a solid tumor. They have established the use of entecavir prophylaxis for HB surface antigen (HBsAg)-positive patients and the monitoring of HBsAg-negative patients who are positive for HBV core antibody. In a Markov model analysis, the authors discovered that the screening all strategy was the most cost-effective, with an incremental cost-effectiveness ratio of $42,761 vs screening only high-risk patients. For all estimates of the prevalence of HBsAg-positive patients and estimates of HBV reactivation in HBsAg-positive patients, the screen-all strategy was the most cost-effective. When more than 25% of high-risk patients were screened for HBV infection, screening only high-risk patients was the most cost-effective strategy. Recommendation of HBV testing should be considered in patients starting chemotherapy.