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The impact of genital warts: loss of quality of life and cost of treatment in eight sexual health clinics in the UK
  1. S C Woodhall1,2,
  2. M Jit2,
  3. K Soldan2,
  4. G Kinghorn3,
  5. R Gilson4,
  6. M Nathan5,
  7. J D Ross6,
  8. C J N Lacey1 on behalf of the QOLIGEN study group
  1. 1Hull York Medical School, University of York, York, UK
  2. 2Health Protection Agency, London, UK
  3. 3Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
  4. 4Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, and Camden Provider Services, London, UK
  5. 5Department of Sexual Health, Homerton University Hospital, London, UK
  6. 6Whittall Street Clinic, Birmingham, UK
  1. Correspondence to S C Woodhall, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ, UK; sarah.woodhall{at}


Objectives To estimate the loss of quality of life and cost of treatment associated with genital warts seen in sexual health clinics.

Methods A cross-sectional questionnaire study and case note review of individuals with genital warts, carried out in eight sexual health clinics in England and Northern Ireland. Individuals with genital warts attending the participating clinics were invited to take part in the questionnaire study. 895 participants were recruited. A separate sample of 370 participants who had attended a participating clinic with a first visit for a first or recurrent episode of genital warts between April and June 2007 was included in the case note review. Quality of life was measured using the EQ-5D questionnaire and the cost of an episode of care was derived from the case note review.

Results The weighted mean EQ-5D index score was 0.87 (95% CI 0.85 to 0.89). The weighted mean disutility was 0.056 (95% CI 0.038 to 0.074). The estimated mean loss of quality-adjusted life-years associated with an episode of genital warts was 0.018 (95% CI 0.0079 to 0.031), equivalent to 6.6 days of healthy life lost per episode. The weighted mean cost per episode of care was £94 (95% CI £84 to £104), not including the cost of a sexually transmitted infection screen.

Conclusions Genital warts have a substantial impact on the health service and the individual. This information can be utilised for economic evaluation of human papillomavirus vaccination.

  • Acyclovir
  • AIN
  • antivirals
  • cervical cancer
  • cervix
  • chlamydia
  • epidemiology
  • genital infection
  • genitourinary MED
  • GUM
  • GUM clinics
  • GUM services
  • penile warts
  • PID
  • podophyllin
  • podophyllotoxin
  • STD services
  • trials
  • urethral warts
  • viral vaccines

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  • Funding The study was funded by a grant to the HPA from the Department of Health Policy Research programme (039/0030). The views expressed are not necessarily those of the department. The authors' work was independent of the funders, who had no role in the design, collection, analysis or interpretation of the data, or in the decision to submit the article for publication.

  • Competing interests CJNL and JDR have received travel/accommodation costs from GlaxoSmithKline (GSK) and Sanofi Pasteur MSD (SPMSD); MN has received payment from GSK for delivering a lecture and associated travel; JDR has received payment from GSK and SPMSD for delivering educational lectures and consultancy. KS's institution has received grants from/has funding arrangements with GSK for projects outside of this study.

  • Patient consent Completion of the questionnaire was considered as consent, as confirmed by the research ethics committee review. Consent was not sought for the case note review—only members of the usual clinical care team had access to identifiable information.

  • Ethics approval The study was approved by the South Humber research ethics committee.

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