rss
Sex Transm Infect 78:425-429 doi:10.1136/sti.78.6.425
  • Original Article

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

  1. R V Barnabas1,2,
  2. H Carabin2,
  3. G P Garnett2
  1. 1Nuffield Department of Medicine, University of Oxford, Oxford, UK
  2. 2Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, St Mary’s, London, UK
  1. Correspondence to:
 G P Garnett, Department Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, St Mary’s, Norfolk Place, London W2 1PG, UK;
 g.garnett{at}ic.ac.uk
  • Accepted 20 June 2002

Abstract

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.

Footnotes

    Free sample

    This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of STI.
    View free sample issue >>

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

    Navigate This Article