Projection of the future dimensions and costs of the genital herpes simplex type 2 epidemic in the United States
Projection of the future dimensions and costs of the genital herpes simplex type 2 epidemic in the United States
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DOI：
10.1097/00007435-200210000-00008
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发表时间：
2002-10-01
影响因子：
3.1
通讯作者：
Goldie, SJ
中科院分区：
文献类型：
--
作者：
Fisman, DN;Lipsitch, M;Goldie, SJ
背景。目前，2 型单纯疱疹病毒 (HSV-2) 感染影响着大约 22% 的美国成年人，并且在 20 世纪 70 年代末至 90 年代初，感染率显着上升。尽管可以对 HSV-2 引起的流行性疾病的成本进行一些估计，但预防 HSV-2 感染的干预措施的选择以及对其潜在成本效益的评估，应考虑到如果不采取措施减缓流行病，预计未来将产生的成本。 目标：目标是估计在没有减缓流行病的干预措施的情况下，HSV-2 流行病造成的未来健康和经济后果。研究设计：建立了一个数学模型来预测美国 HSV-2 血清流行率未来的增长。 HSV-2 异性传播的概率是根据国家健康和营养检查调查 (NHANES) 报告的感染流行率的横断面估计来估计的。每次感染的预期成本是根据已发表的医学文献中获得的数据计算的。结果：如果不采取干预措施，到 2025 年，15 至 39 岁人群中 HSV-2 感染率预计将增至男性的 39%，女性的 49%。预计年发病率将在 2000 年至 2025 年间稳步上升，从每 1000 名男性 9 例感染到 26 例感染，从每 1000 名男性 12 例感染到 32 例感染。这个年龄段的女性有 1000 名。 2000 年事件感染造成的损失估计为 18 亿美元；预计到 2015 年，突发事件感染造成的损失将增至 25 亿美元，到 2025 年将增至 27 亿美元。预计未来 25 年发生的 HSV-2 突发事件感染造成的累计成本预计将达到 610 亿美元；按 3% 的贴现率计算，这笔金额的现值为 430 亿美元。 结论：在美国，HSV-2 感染事件造成的损失是巨大的，并且随着本世纪上半叶该疾病的发病率和流行率的增加，预计该损失还会增加。 HSV-2 预防策略的资源分配水平应反映控制这一流行病所带来的经济效益。
Background. Infection with herpes simplex virus type 2 (HSV-2) currently affects approximately 22% of adult Americans and increased markedly in prevalence between the late 1970s and early 1990s. Although some estimates of the costs of prevalent disease due to HSV-2 are available, selection of interventions to prevent HSV-2 infection, as well as evaluation of their potential cost-effectiveness, should take into account projected future costs that will result if the epidemic is left unchecked.Goal: The goal was to estimate the future health and economic consequences attributable to the HSV-2 epidemic in the absence of interventions to slow the epidemic. Study Design: A mathematical model was constructed to project future increases in HSV-2 seroprevalence in the United States. The probability of heterosexual transmission of HSV-2 was estimated from cross-sectional estimates of infection prevalence reported by the National Health and Nutrition Examination Survey (NHANES). Per-infection expected costs were calculated on the basis of data obtained from the published medical literature.Results: Without intervention, the prevalence of HSV-2 infection among individuals aged 15 to 39 years was projected to increase to 39% among men and 49% among women by 2025. Annual incidence was projected to increase steadily between 2000 and 2025, from 9 to 26 infections per 1000 men and from 12 to 32 infections per 1000 women in this age group. The cost of incident infections in the year 2000 were estimated to be $1.8 billion; the cost of incident infections was predicted to rise to $2.5 billion by 2015 and $2.7 billion by 2025. The projected cumulative cost of incident HSV-2 infections occurring over the next 25 years was estimated to be $61 billion; at a 3% discount rate, this sum has a present value of $43 billion.Conclusion: The costs of incident HSV-2 infection in the United States are substantial and can be expected to increase as both the incidence and prevalence of this disease increase in the first half of the century. The level of resource allocation for HSV-2 prevention strategies should reflect the economic benefits that would result from control of this epidemic.