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HSV testing - it's a matter of time From: Efrain Ramirez (eramirezt@coqui.net) Fri Feb 4 10:25:59 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: OB: GBS--recent case" Previous message: art fougner, md: "Re: Washington, D.C., Birthing Center Almost Closes Because of Financial Troubles, Malpractice Premiums" Cost-effectiveness of herpes simplex virus type 2 serologic testing and antiviral therapy in pregnancy David Baker, MD a [MEDLINE LOOKUP] Zane Brown, MD b [MEDLINE LOOKUP] Lisa M. Hollier, MD c [MEDLINE LOOKUP] George D. Wendel Jr., MD d [MEDLINE LOOKUP] Lisa Hulme e [MEDLINE LOOKUP] Dorothea A. Griffiths, MD, PhD f [MEDLINE LOOKUP] Josephine Mauskopf, PhD g * [MEDLINE LOOKUP] 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. -- "The opposite of a correct statement is a false statement. But the opposite of a profound truth may well be another profound truth." Niels Bohr (1885 - 1962) Next message: Garry E. Siegel, M.D.: "Re: OB: GBS--recent case" Previous message: art fougner, md: "Re: Washington, D.C., Birthing Center Almost Closes Because of Financial Troubles, Malpractice Premiums"

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