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;
  • Accepted 20 June 2002


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.