Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study.
Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study.
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DOI：
10.1016/j.lana.2023.100427
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发表时间：
2023-03
期刊：
影响因子：
--
通讯作者：
Roenn, Minttu M.
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文献类型：
--
作者：
You, Shiying;Yaesoubi, Reza;Lee, Kyueun;Li, Yunfei;Eppink, Samuel T.;Hsu, Katherine K.;Chesson, Harrell W.;Gift, Thomas L.;Berruti, Andres A.;Salomon, Joshua A.;Roenn, Minttu M.
关键词：
生殖器疱疹(GH)是由单纯疱疹病毒1型和2型(HSV-1，HSV-2)引起的一种常见的性传播疾病，与不良健康结局有关。与生长激素爆发相关的症状可以通过抗病毒药物来减少，但这种感染是无法治愈的，而且是终生的。在这项研究中，我们使用失去的质量调整寿命年(QALY)来估计美国生长激素对健康的长期影响。我们使用概率树来模拟18-49岁人群中因感染HSV-1和HSV-2而继发的生长激素自然病史。我们对以下结果进行建模，以量化感染后健康损失的主要原因：症状性疱疹暴发、与诊断和复发相关的心理社会影响、由骶骨神经根炎、无菌性脑膜炎、Mollaret脑膜炎和新生儿疱疹引起的尿潴留。该模型是根据已发表的生长激素自然史文献进行参数化的。我们通过计算每个生殖器HSV-1和HSV-2感染失去的QALY的终生数量来总结健康损失，并将这些信息与发病率估计结合起来计算2018年美国因感染而失去的QALY的终生总数。我们估计2018年每个GH感染事件损失0.05(95%不确定区间(UI)0.02-0.08)终生QALY，相当于一个完全健康的人失去0.05年或约18天的生命。生殖器HSV-1和HSV-2感染的平均QALY丢失数分别为0.01(95%UI0.01~0.02)和0.05(95%UI0.02~0.09)。女性生殖器HSV-1感染负担较高，而男性HSV-2感染负担较高。每例新生儿疱疹感染丢失的QALY估计为7.93(95%UI 6.63-9.19)。在人口层面，2018年由于成人生长激素感染而损失的估计终身QALY总数为33,100人(95%UI 12,600-67,900)，因新生儿疱疹而损失的QALY总数为3,140人(95%UI 2,260-4,140)。结果对与诊断后心理社会苦恼和症状复发相关的不良后果的程度的假设最为敏感。在美国，生长激素与大量的健康损失有关。这项研究的结果可以用来比较生长激素与其他疾病的负担，它提供的信息可用于研究旨在减轻生长激素负担的干预措施对健康的影响和成本效益。这个
Genital herpes (GH), caused by herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), is a common sexually transmitted disease associated with adverse health outcomes. Symptoms associated with GH outbreaks can be reduced by antiviral medications, but the infection is incurable and lifelong. In this study, we estimate the long-term health impacts of GH in the United States using quality-adjusted life years (QALYs) lost. We used probability trees to model the natural history of GH secondary to infection with HSV-1 and HSV-2 among people aged 18–49 years. We modelled the following outcomes to quantify the major causes of health losses following infection: symptomatic herpes outbreaks, psychosocial impacts associated with diagnosis and recurrences, urinary retention caused by sacral radiculitis, aseptic meningitis, Mollaret's meningitis, and neonatal herpes. The model was parameterized based on published literature on the natural history of GH. We summarized losses of health by computing the lifetime number of QALYs lost per genital HSV-1 and HSV-2 infection, and we combined this information with incidence estimates to compute the total lifetime number of QALYs lost due to infections acquired in 2018 in the United States. We estimated 0.05 (95% uncertainty interval (UI) 0.02–0.08) lifetime QALYs lost per incident GH infection acquired in 2018, equivalent to losing 0.05 years or about 18 days of life for one person with perfect health. The average number of QALYs lost per GH infection due to genital HSV-1 and HSV-2 was 0.01 (95% UI 0.01–0.02) and 0.05 (95% UI 0.02–0.09), respectively. The burden of genital HSV-1 is higher among women, while the burden of HSV-2 is higher among men. QALYs lost per neonatal herpes infection was estimated to be 7.93 (95% UI 6.63–9.19). At the population level, the total estimated lifetime QALYs lost as a result of GH infections acquired in 2018 was 33,100 (95% UI 12,600–67,900) due to GH in adults and 3,140 (95% UI 2,260–4,140) due to neonatal herpes. Results were most sensitive to assumptions on the magnitude of the disutility associated with post-diagnosis psychosocial distress and symptomatic recurrences. GH is associated with substantial health losses in the United States. Results from this study can be used to compare the burden of GH to other diseases, and it provides inputs that may be used in studies on the health impact and cost-effectiveness of interventions that aim to reduce the burden of GH. The
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