Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study.

Autor:	You S; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA., Yaesoubi R; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA., Lee K; Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA., Li Y; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Eppink ST; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Hsu KK; Division of Sexually Transmitted Disease Prevention & HIV/AIDS Surveillance, Massachusetts Department of Public Health, Boston, MA, USA., Chesson HW; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Gift TL; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Berruti AA; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Salomon JA; Center for Health Policy / Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA., Rönn MM; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2023 Feb 07; Vol. 19, pp. 100427. Date of Electronic Publication: 2023 Feb 07 (Print Publication: 2023).
DOI:	10.1016/j.lana.2023.100427
Abstrakt:	Background: Genital herpes (GH), caused by herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), is a common sexually transmitted disease associated with adverse health outcomes. Symptoms associated with GH outbreaks can be reduced by antiviral medications, but the infection is incurable and lifelong. In this study, we estimate the long-term health impacts of GH in the United States using quality-adjusted life years (QALYs) lost. Methods: We used probability trees to model the natural history of GH secondary to infection with HSV-1 and HSV-2 among people aged 18-49 years. We modelled the following outcomes to quantify the major causes of health losses following infection: symptomatic herpes outbreaks, psychosocial impacts associated with diagnosis and recurrences, urinary retention caused by sacral radiculitis, aseptic meningitis, Mollaret's meningitis, and neonatal herpes. The model was parameterized based on published literature on the natural history of GH. We summarized losses of health by computing the lifetime number of QALYs lost per genital HSV-1 and HSV-2 infection, and we combined this information with incidence estimates to compute the total lifetime number of QALYs lost due to infections acquired in 2018 in the United States. Findings: We estimated 0.05 (95% uncertainty interval (UI) 0.02-0.08) lifetime QALYs lost per incident GH infection acquired in 2018, equivalent to losing 0.05 years or about 18 days of life for one person with perfect health. The average number of QALYs lost per GH infection due to genital HSV-1 and HSV-2 was 0.01 (95% UI 0.01-0.02) and 0.05 (95% UI 0.02-0.09), respectively. The burden of genital HSV-1 is higher among women, while the burden of HSV-2 is higher among men. QALYs lost per neonatal herpes infection was estimated to be 7.93 (95% UI 6.63-9.19). At the population level, the total estimated lifetime QALYs lost as a result of GH infections acquired in 2018 was 33,100 (95% UI 12,600-67,900) due to GH in adults and 3,140 (95% UI 2,260-4,140) due to neonatal herpes. Results were most sensitive to assumptions on the magnitude of the disutility associated with post-diagnosis psychosocial distress and symptomatic recurrences. Interpretation: GH is associated with substantial health losses in the United States. Results from this study can be used to compare the burden of GH to other diseases, and it provides inputs that may be used in studies on the health impact and cost-effectiveness of interventions that aim to reduce the burden of GH. Funding: The Center for Disease Control and Prevention. Competing Interests: MMR reports contract for work on cervical cancer elimination modeling in South Africa, not related to the manuscript, from World Health Organization, travel and lodging support for attending a research project meeting at the World Health Organization headquarters in Geneva, Switzerland, not related to the manuscript, from World Health Organization. YL reports postdoctoral fellowship stipend (2020–2022) from Harvard T. H. Chan School of Public Health, not related to the manuscript. SY reports doctoral stipend from New York University Grossman School of Medicine, not related to the manuscript. All other authors report no potential conflicts. (© 2023 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu