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Health Care Costs and Financing

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Costs associated with genital herpes are expected to rise swiftly over the next 10 years

More than one in five adult Americans (22 percent) has genital herpes caused by infection with the herpes simplex virus type 2 (HSV-2). Without intervention, the prevalence of HSV-2 infection among individuals aged 15 to 39 years is projected to increase to 39 percent among men and 49 percent among women and to cost $2.5 billion by 2015, according to a study supported by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00020).

This predominantly sexually transmitted disease, which can also be transmitted from mother to baby during childbirth, can cause primary and recurrent genital ulceration, problems in relationships, and depression. Infected women often undergo cesarean sections to avoid infecting their babies, who can suffer from serious disability or death if infected.

Given the projected economic burden that is likely to be imposed on society by the HSV-2 epidemic, substantial investment in HSV-2 prevention strategies makes economic sense, concludes David N. Fisman, M.D., M.P.H., F.R.C.P., of McMaster University.

Dr. Fisman and his colleagues constructed a mathematical model to project future increases in HSV-2 seroprevalence in the United States using data reported by the National Health and Nutrition Examination Survey. They calculated per-infection expected costs ($620 for men and $510 for women) based on data from published research studies.

The researchers projected the annual incidence of HSV-2 to increase steadily between 2000 and 2025, from 9 to 26 infections per 1,000 men and from 12 to 32 infections per 1,000 women in this age group. They also projected an incidence of neonatal HSV-2 infection of 29 cases per 100,000 live births by 2025. They predicted the cost of infection to rise from $1.8 billion in 2000 to $2.5 billion by 2015 and $2.7 billion by 2025. Prevention programs currently being formulated to slow the spread of genital herpes include blood screening to identify asymptomatic infected individuals, programs to increase use of condoms, suppressive antiviral therapy to prevent viral shedding, and promising new vaccines.

More details are in "Projection of the future dimensions and costs of the genital herpes simplex type 2 epidemic in the United States," by Dr. Fisman, Marc Lipsitch, D.Phil., Edward W. Hook III, M.D., and Sue J. Goldie, M.D., M.P.H., in the October 2002 Sexually Transmitted Diseases 29(10), pp. 608-622.

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