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.
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.
Authors: A Mindel; J Taylor; R L Tideman; C Seifert; G Berry; K Wagner; J Page; C Marks; B Trudinger; A Cunningham Journal: Sex Transm Infect Date: 2000-08 Impact factor: 3.519
Authors: D W Kimberlin; C Y Lin; R F Jacobs; D A Powell; L M Frenkel; W C Gruber; M Rathore; J S Bradley; P S Diaz; M Kumar; A M Arvin; K Gutierrez; M Shelton; L B Weiner; J W Sleasman; T M de Sierra; S J Soong; J Kiell; F D Lakeman; R J Whitley Journal: Pediatrics Date: 2001-08 Impact factor: 7.124
Authors: Z A Brown; J Benedetti; R Ashley; S Burchett; S Selke; S Berry; L A Vontver; L Corey Journal: N Engl J Med Date: 1991-05-02 Impact factor: 91.245
Authors: Bharat S Parekh; Chin-Yih Ou; Peter N Fonjungo; Mireille B Kalou; Erin Rottinghaus; Adrian Puren; Heather Alexander; Mackenzie Hurlston Cox; John N Nkengasong Journal: Clin Microbiol Rev Date: 2018-11-28 Impact factor: 26.132
Authors: Helen C Stankiewicz Karita; Nicholas J Moss; Ellen Laschansky; Linda Drolette; Amalia S Magaret; Stacey Selke; Carolyn Gardella; Anna Wald Journal: Open Forum Infect Dis Date: 2017-11-06 Impact factor: 3.835