Table 5.
Summary of primary studies for measuring the quality of life of people living with herpes
| Lead author | Study aims | Participants (n) | Country | Year(s) collected data | Techniques used, health states valued and results | Type of valuation |
|---|---|---|---|---|---|---|
| Utility studies | ||||||
| Bartlett [26] | Assess time to first recurrence and change in RGHQoL for episodic and suppressive famciclovir | Immunocompetent adults with recurrent genital herpes (384) | USA | Published 2008* |
RGHQoL = mean Episodic famciclovir at baseline = 30.7 Episodic famciclovir at the end of study = 33.5 Suppressive famciclovir at baseline = 29.3 Suppressive famciclovir at the end of study (30 days after the last dose) = 34.0 |
Indirect |
| Bodsworth [27] | Demonstrate that a 2-day course of famciclovir 500 mg stat, then 250 mg twice daily was non-inferior to the standard 5-day course of 125 mg twice daily | Immunocompetent adults with recurrent genital herpes (873) | Australia & Canada | 2003–2006 |
HSC = mean (SD) 2-day famciclovir = 4.77 (3.76) 5-day famciclovir = 4.98 (3.83) HOIQ = mean (SD) 2-day famciclovir = 5.70 (5.12) 5-day famciclovir = 5.78 (5.29) |
Indirect |
| Fife [28] | Compare episodic and suppressive therapy for genital herpes about disease characteristics, disease burden, and psychological impact | Healthy adults with a history of 4–9 genital herpes recurrences per year for at least one year (80) | USA | 1999–2000 |
SF-36 Not reported. (No difference between study arms.) RGHQoL ~ mean (estimated from a figure) Genital herpes with episodic treatment at baseline ~ 26 Genital herpes with episodic treatment at month 12 ~ 21 Genital herpes with suppressive treatment ~ 22.5 Genital herpes with suppressive treatment at month 12 ~ 15 |
Indirect |
| Fisman [31] | Evaluate the use of several utility-based tools for assessment of health-related quality of life in a population of individuals with symptomatic genital herpes | Individuals with recurrent genital herpes (39) | Canada | Published 2005* |
TTO: mean (SD) Asymptomatic genital herpes = 0.89 (0.21) Symptomatic genital herpes = 0.89 (0.22) VAS: mean (SD) Asymptomatic genital herpes = 0.76 (0.30) Symptomatic genital herpes = 0.71 (0.30) HUI-2: mean (SD) Transient symptomatic = 0.93 (0.08) Asymptomatic = 0.80 (0.16) RGHQoL: median (range) Study population = 20 (1–57) |
Direct |
| Foster [36] | Investigate the extent to which stigma experiences, individual characteristics, and STI characteristics were associated with multiple aspects of sexual well-being among individuals diagnosed with herpes and/or HPV | Individuals with herpes and/or human papillomavirus (188: 83 had herpes and 79 were co-infected) | Canada | Published 2016* |
Sexual Anxiety Inventory = mean (SD) Individual with STI = 33.7 (11.1) Sexual Self-Schema Scale-Revised ‘moderately positive self-schemas’ = 129.5 (30.0) Sexual Self-Esteem Scale ‘moderately high levels of sexual self-esteem’ = 30.4 (7.3) GMSEX-R (sexual satisfaction) = mean (SD) Individual with STI = 25.2 (6.2) |
Indirect |
| Langley [35] | Assess the impact of genital herpes and extragenital warts on current health-related quality of life at the general population level | Herpes patients obtained from a general population sample (520 with genital herpes, 63 were co-infected) | UK, France, Spain, Italy and Germany | 2008 |
SF-6D: mean + 95% CI Genital herpes = − 3.52 (− 4.63 to – 2.71) External genital warts and genital herpes = − 5.00 (− 1.76 to – 8.25) |
Indirect |
| Mehta [11] | Assess SQoL among heterosexual couples in Kisumu, Kenya, and how this was associated with HIV status, STIs, and sexual practices | 252 couples (53% women were HSV-2 + , 47% men were HSV-2 +) | Kenya | 2014–2017 |
SQoL2 = mean Men = 87.7 (21.9) Women = 78.2(20.6) Note: mixed infection with HIV, HSV-2 and bacterial vaginosis |
Indirect |
| Meyer [38] | Measure the psychosocial response to a new serological HSV-2 diagnosis in patients receiving care at an urban HIV clinic prospectively | HIV-infected adults, aged 18–55 (248) | USA | 2001–2002 |
25 herpes specific questions1 = mean (SD) HSV-2 + with previous history at 2 weeks = 73.7 (12.4) HSV-2 + with previous history at 3 months = 73.8 (12.6); HSV-2 + with previous history at 6 months = 75.4 (10.8); HSV-2 + without previous history at 2 weeks = 76.4 (14.0) HSV-2 + without previous history at 3 months = 75.0 (15.7) HSV-2 + without previous history at 6 months = 76.8 (14.4) |
Indirect |
| Patel [39] | To investigate whether suppressive antiviral therapy improves health-related quality of life in patients with recurrent genital herpes | Participants in a randomised clinical trial comparing herpes therapy options (1349) | USA, UK, Denmark, France, Australia, New Zealand, Italy, Austria, & Germany | Published 1999* |
RGHQoL = mean score Baseline = ranged from 30.2 to 33.9 depending on six treatment groups At 12 months, the adjusted mean improvement from baseline in the active treatment groups ranged from 9.4 to 12.0 compared with a mean improvement of 4.8 points in the placebo group |
Indirect |
| Raj [12] | Compare the HRQOL in patients with HIV, genital HPV, and HSV-2 infections and healthy controls | HSV-2 + adults attending a sexually transmitted diseases clinic (60) | India | 2008–2009 |
WHOQOL-BREF = Mean (CI) Physical domain (domain I) = 28.5 (24.8–32.2) Psychological domain (domain II) = 34.3 (30.5–38.1) Social domain (domain III) = 36.9 (31.5–42.3) Environmental domain (domain IV) = 41.3 (37.8–44.8) Total QOL score = 141.0 (128.1–153.9) |
Indirect |
| Richards [37] | Measure the uptake of HSV-2 testing and psychosocial response to a new serologic diagnosis of HSV-2 in a health maintenance organisation (HMO) population prospectively | HSV-2 + adults, aged 18 + (87: 44 did not have a prior diagnosis) | USA | 2002–2003 |
HRQoL = mean score (SD) HSV-2 + with prior diagnosis at 2 weeks = 77.2 (7.4) HSV-2 + with prior diagnosis at 3 months = 77.6 (8.5) HSV-2 + with prior diagnosis at 6 months = 77.4 (7.8) HSV-2 positive without prior diagnosis at 2 weeks = 74.9 (12.9) HSV-2 positive without prior diagnosis at 3 months = 79.8 (10.9) HSV-2 positive without prior diagnosis at 6 months = 77.6 (14.1) |
Indirect |
| Romanowski [29] | Assess patients’ preference, satisfaction, and quality of life with suppressive versus episodic treatment of recurrent genital herpes | Immunocompetent adults (aged 18 +) with a documented history of genital HSV-1 or HSV-2 infection (225) | Canada | Published 2003* |
RGHQoL: Mean Score (95% CI) Suppressive therapy week 12 = 59.6 (56.90 to 62.30) Suppressive therapy week 24 = 60.9 (58.32 to 63.54) Suppressive therapy week 36 = 59.9 (57.05 to 62.78) Suppressive therapy week 48 = 61.1 (58.29 to 63.86) Episodic therapy week 12 = 56.0 (53.22 to 58.72) Episodic therapy week 24 = 56.6 (53.71 to 59.45) Episodic therapy week 36 = 60.7 (57.56 to 63.77) Episodic therapy week 48 = 61.7 (58.70 to 64.69) |
Indirect |
| Spencer [32] | Describes the impact of the disease on quality of life in a French population and used to provide additional validation data for the French version of the RGHQoL measure | Herpes patients obtained from a general population sample (150) | France | Published 1999* |
RGHQoL = mean (SD) Men = 51.0 (6.5) Women = 50.8 (8.7) |
Indirect |
| Taboulet [34] | Assess psychological morbidity in France related to genital herpes infection | Adults with recurrent genital herpes (150) | France | 1995 |
SF-36 = mean (SD) physical functioning = 85.78 (20.82) physical role = 83.95 (29.88) bodily pain = 73.17 (25.41) general health = 68.39 (21.74) vitality = 55.37 (18.40) social functioning = 78.63 (21.54) emotional role = 76.01 (32.60) mental health = 60.75 (18.81) reported health = 47.47 (17.68) |
Indirect |
| Wild [30] | Develop a herpes-specific quality of life measure | Adults with recurrent genital herpes (69) | USA | Published 1995* |
“25 Herpes-specific questions” = mean (SD) mild severity of outbreak = 77.2 (16.1) moderate severity of outbreak = 67.4 (19.1) outbreaks in past 12 months = 82.1 (17.1) 2 + outbreaks in past 12 months = 72.1 (17.4) |
Indirect |
| Wylomanski [33] | Test the hypothesis that vulvar disease patients have an overall impaired sexual well-being that varies depending on the type of vulvar disease | Patients with vulvar disease (72: 2 with vulvar herpes) | France | 2011–2013 |
FSFI = median (IQR) Patients with VD (2 of 72 had vulvar herpes) = 21.1 (IQR: 13.4–26.5) |
Indirect |
| James [13]‡ | Quantify non-fatal health outcomes in terms of incidence, prevalence, and years of life with disability for a list of 354 Global Burden of Disease causes for the years 1990–2017 | Unclear | Global | 1990–2017 |
Disability weight = base value (95% uncertainty interval) Moderate infection due to initial genital herpes episode (infectious disease, acute episode, moderate) = 0.051 (0.032–0.074) Symptomatic genital herpes (infectious disease, acute episode, mild) = 0.006 (0.002–0.012) |
Unclear |
| Salomon [14]‡ |
Estimate an updated set of disability weights for Global Burden of Disease 2013 via new data collection in four European countries and a reanalysis of existing and new data combined |
Adults, aged 18 + | Global | 2009–2010 and 2013 |
Disability weight = base value (95% uncertainty interval) Infectious disease: acute episode, mild = 0.006 (0.002–0.012) Infectious disease: acute episode, moderate = was 0.051 (0.032–0.074) Infectious disease: acute episode, severe = 0.133(0.088–0.190) |
Unclear |
| Salomon [15]‡ | Re-estimate disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach | Adults, aged 18 + | Global | 2009–2011 |
Disability weight = base value (95% uncertainty interval) Infectious disease: acute episode, mild = 0.005 (0.002–0.011) Infectious disease: acute episode, moderate = 0.053 (0.033–0.081) Infectious disease: acute episode, severe = 0.210 (0.139–0.298) |
Unclear |
sFSFI Female Sexual Function Index; GMSEX-R Global Measure of Sexual Satisfaction; HOIQ Herpes Outbreak Impact Questionnaire; HRQoL Health-related Quality of Life; HSC Herpes Symptom Checklist; HUI-2 Health utilities index; MOS SF-36 Medical Outcome Study Short Form 36-item Health Survey; QoL Quality of Life; RGHQoL Recurrent Genital Herpes Quality of Life; SQoL Sexual Quality of Life; STI sexually transmitted infection; TTO time trade-off; VAS visual analogue scale; WHOQOL-BREF WHO Quality of Life instrument
*These studies do not state when data were collected
‡These are disutility studies
1These were scored on a 4-point scale
2SQoL was assessed with an 18-item female and 11-item male survey