Health related quality of life in genital herpes: a pilot comparison of measures

Background: Genital herpes (GH) is a common sexually transmitted infection. Novel tools for the control of GH ( for example, tests and vaccines) are emerging, but optimal assessment of the cost effectiveness of such interventions requires scaled, preference based estimates of the impact of GH on health related quality of life. Methods: We provided self administered interviews to 39 individuals with recurrent GH recruited from an STD clinic and a GH support group in southern Ontario, Canada. Health preference estimates were generated using visual analogue scales ( VAS), a time-tradeoff approach (TTO) and the Health Utilities Index Mark-II (HUI-II). Quality of life was also assessed with the Recurrent Genital Herpes Quality of Life scale (RGHQoL). Results: Average (SD) health values for asymptomatic and symptomatic genital herpes were 0.89 (0.21) and 0.89 (0.22) using TTO, and 0.76 (0.30) and 0.71 ( 0.30) using VAS. Health utility estimates generated with HUI-II for transient symptomatic and asymptomatic health states were 0.93 (0.08) and 0.80 (0.16). Log transformed health value estimates exhibited convergent validity when compared to RGHQoL, as did health utility estimates for symptomatic GH. Utility scores for symptomatic GH increased ( improved) with increasing age; no other subject characteristic was predictive of preference weights. Conclusions: Preference based measures of health related quality of life can be elicited with relative ease in the context of genital herpes, and preference weights are correlated with quality of life scores generated using the RGHQoL. Generation of preference weights will permit direct comparison of the economic attractiveness of herpes prevention interventions with that of other commonly available health interventions.