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Clinical
Loss of quality of life associated with genital warts: baseline analyses from a prospective study
  1. Martin Sénécal1,
  2. Marc Brisson2,3,
  3. Elizabeth Maunsell2,3,
  4. Alex Ferenczy4,5,
  5. Eduardo L Franco4,
  6. Sam Ratnam6,
  7. François Coutlée7,
  8. Joel M Palefsky8,
  9. James A Mansi1
  1. 1Merck Frosst Canada Ltd., Montréal, Québec, Canada
  2. 2Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
  3. 3Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Québec, Québec, Canada
  4. 4McGill University, Montréal, Québec, Canada
  5. 5Jewish General Hospital, Montréal, Québec, Canada
  6. 6Provincial Public Health Laboratory, St John's, Newfoundland Labrador, Canada
  7. 7Hôpital Notre-Dame du CHUM, Montréal, Québec, Canada
  8. 8University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Marc Brisson, Canada Research Chair in Mathematical Modeling and Health Economics of Infectious Disease, Laval University, Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Canada G1S 4L8; marc.brisson{at}uresp.ulaval.ca

Abstract

Objective The quadrivalent human papillomavirus (HPV) vaccine is effective against HPV types responsible for 90% of anogenital warts. This study estimated the quality of life lost to genital warts using the EQ-5D, a generic instrument widely used for applications in economic analyses. The findings are described in terms that are more specific to individuals with genital warts using psychosocial questions adapted from the HPV impact profile, a measure developed for HPV-related conditions.

Methods Between September 2006 and February 2008, 42 physicians across Canada recruited 330 consenting patients 18 years and older with genital warts, either at the first or follow-up visit for an initial or recurrent episode. The quality of life lost associated with genital warts was estimated by the difference between participants' EQ-5D scores and age and gender-specific population norms.

Results The study questionnaire was self-completed by 270 participants who were aged 31.5 years (SD 10.4) on average. The majority of participants were women (53.3%), heterosexual (93.5%) and in a stable relationship (66.0%). Genital warts were associated with detriments in the EQ-5D domains of anxiety/depression, pain/discomfort and usual activities. The absolute difference in the EQ-5D utility score and the EQ-VAS health status between genital warts patients and population norms was 9.9 (95% CI 7.3 to 12.5) and 6.0 (95% CI 4.1 to 7.9) percentage points, respectively. These results did not vary significantly according to patient age, gender, time since first episode or number of episodes.

Conclusion The results suggest that genital warts negatively affect the wellbeing of men and women as reflected by poorer quality of life scores compared with population norms.

  • Genital warts
  • human papillomavirus
  • HPV
  • psychosocial
  • quality of life

https://doi.org/10.1136/sti.2009.039982

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    Footnotes

    • Funding Financial support for this study was provided by Merck Frosst Canada Ltd.

    • Competing interests MS is employed by Merck Frosst Canada Ltd. MB was an employee of Merck Frosst Canada Ltd from 2003 to 2006. Since November 2006, he has been an assistant professor at Laval University. MB has consulted for Merck Frosst in 2007; he has received reimbursement for travel expenses from GlaxoSmithKline in 2007. EM consulted for Merck Frosst in 2006. AF is a member of the Clinical Advisory Board and Speakers' Bureau for Merck & Co. ELF has served as occasional advisor to companies involved with human papillomavirus (HPV) vaccination or diagnostics (Merck Frosst, GlaxoSmithKline, Gen-Probe, Roche and Qiagen). He has received unconditional grant support from Merck Frosst in support of his own investigator-initiated research on epidemiology and screening. SR received a research grant from Merck Frosst in 2006–7, which dealt with assessment of HPV tests in cervical cancer screening. FC has served as occasional advisor to companies involved with HPV vaccination or diagnostics (Merck Frosst and Roche Molecular Systems). JMP received research grant support from Merck and Co. JAM was an employee of Merck Frosst Canada Ltd (July 1997 to January 2010) during protocol development, study execution and manuscript submission.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the Canadian SHIELD Ethics Review Board and the College of Physicians and Surgeons of Alberta.

    • Provenance and peer review Not commissioned; externally peer reviewed.