Table 5 Summary of primary studies for measuring the quality of life of people living with herpes

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