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

From: Health-related quality of life in individuals with genital herpes: a systematic review

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
  1. 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
  2. *These studies do not state when data were collected
  3. These are disutility studies
  4. 1These were scored on a 4-point scale
  5. 2SQoL was assessed with an 18-item female and 11-item male survey