The potential role of suppressive therapy for sex partners in the prevention of neonatal herpes: a health economic analysis.

Autor:	Barnabas, R.V., Carabin, H., Garnett, G.P.
Předmět:	PREVENTIVE medicine MEDICAL screening NEONATAL infections HERPESVIRUS diseases PREVENTION of communicable diseases PREVENTION of pregnancy complications HERPES genitalis prevention COMMUNICABLE disease epidemiology ACYCLOVIR ANTIVIRAL agents COMMUNICABLE diseases COMPARATIVE studies COST effectiveness HERPES genitalis RESEARCH methodology MEDICAL cooperation PREGNANCY complications PRENATAL care PRENATAL diagnosis QUESTIONNAIRES RESEARCH EVALUATION research DISEASE incidence VERTICAL transmission (Communicable diseases) SEXUAL partners INFECTIOUS disease transmission THERAPEUTICS
Zdroj:	Sexually Transmitted Infections; Dec2002, Vol. 78 Issue 6, p425-429, 5p, 1 Diagram, 3 Charts, 2 Graphs
Abstrakt:	Background: The development of suppressive therapy and type specific tests for herpes infections allow for screening to reduce the risk of neonatal herpes.Objectives: To assess the potential effectiveness, cost effectiveness, and benefit of suppressive therapy among herpes simplex virus serodiscordant sex partners during pregnancy.Methods: Decision and economic analyses are used to compare the incidence and costs of neonatal herpes in California (2000) for three interventions: (1) no management; (2) current guidelines (caesarean delivery for women with lesions); (3) screening for women at risk and use of suppressive treatment in sex partners.Results: Screening and suppressive therapy are the most effective interventions, while current guidelines have limited effectiveness, but the latter provide the most cost effective results.Conclusions: While current guidelines are cost saving, they forgo a potential 82% decrease in neonatal herpes incidence that would be possible with screening and suppressive therapy if society were willing to pay the necessary US$363 000 per case prevented. To evaluate HSV screening and drug therapy completely, clinical trials and an economic assessment of infant mortality "value" to society are required. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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