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Am J Obstet Gynecol. 2004 Dec;191(6):2074-84.

Cost-effectiveness of herpes simplex virus type 2 serologic testing and antiviral therapy in pregnancy.

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  • 1Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Infectious Disease, Health Sciences Center, State University of New York at Stony Brook, Stony Brook, NY, USA.

Abstract

OBJECTIVE:

The purpose of this study was to determine whether serologic testing for herpes simplex virus type 2 (HSV-2) in pregnant women and their partners is cost-effective.

STUDY DESIGN:

A decision analysis model was developed to investigate the cost-effectiveness of providing type-specific serologic testing at week 15 of pregnancy for all women unaware of their HSV-2 status, and offering antiviral suppressive therapy from week 36 until delivery to all seropositive women. This scenario was compared with current care, in which only a minority of women diagnosed with genital herpes (GH) receives antiviral suppressive therapy (AST). In a third scenario, testing is offered to partners of pregnant women who test seronegative, and antiviral suppressive therapy is offered to the partners who test seropositive.

RESULTS:

Compared with current care, offering testing and antiviral suppressive therapy to 100,000 pregnant women resulted in an incremental cost of $3.1 million, 15.7 fewer cases of neonatal herpes, 186 fewer cesarean deliveries, and an incremental cost per quality-adjusted life- year gained (QALY) of $18,680. Offering testing and suppressive therapy to both the pregnant women and their partners resulted in an increased cost of $8.6 million, 16.8 fewer cases of neonatal herpes, 192 fewer cesarean deliveries, and an incremental cost per QALY of $48,946 compared with no testing.

CONCLUSION:

Compared with commonly accepted benchmarks for cost-effectiveness (<$50,000/QALY), type-specific HSV-2 serologic testing of pregnant women may be a cost-effective strategy.

PMID:
15592294
[PubMed - indexed for MEDLINE]
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