More than 1 in 5 adults in the world has genital herpes infection – WHO

About 846 million people between the ages of 15 and 49 are living with genital herpes infections – more than 1 in 5 of this age group worldwide – according to new assessments released today. It is estimated that at least 1 person every second – 42 million people a year – gets a new infection with genital herpes.

Most of the time, these infections cause no or few symptoms. However, in some people they lead to painful genital sores and blisters that can recur throughout life, causing significant discomfort and often requiring multiple visits to the doctor. According to estimates, more than 200 million people aged 15 to 49 had at least one such symptomatic episode in 2020.

Authors of the study, published in the journal Sexually transmitted infectionssay that new treatments and vaccines are needed to reduce the harmful health effects of the herpes virus and control its spread.

“While most people with genital herpes infection have few symptoms, with so many infections, genital herpes still causes pain and distress to millions around the world and strains already overburdened healthcare systems,” said Dr. Meg Doherty, Global Director of HIV, Hepatitis and Sexually Transmitted Infections. Programs in WHO. “Better prevention and treatment options are urgently needed to reduce herpes transmission and will also contribute to reducing HIV transmission.”

There is currently no cure for herpes, although treatments can relieve symptoms. In addition to sores, genital herpes can occasionally lead to serious complications, including neonatal herpes—a rare condition that most likely occurs when a mother first becomes infected in late pregnancy and then passes the virus to her child during childbirth.

There are two types of herpes simplex virus (HSV), known as HSV-1 and HSV-2, both of which can lead to genital herpes. According to estimates, 520 million people in 2020 had genital HSV-2, which is transmitted during sexual activity. From a public health perspective, genital HSV-2 is more serious as it is much more likely to cause recurrent outbreaks, is responsible for about 90% of symptomatic episodes, and is associated with a threefold higher risk of acquiring HIV.

Unlike HSV-2, HSV-1 is primarily spread during childhood through saliva or skin-to-skin contact around the mouth and causes oral herpes, with cold sores or mouth ulcers being the most common symptoms. However, in those without prior infection, HSV-1 can be acquired through sexual contact and cause genital infection in adolescence or adulthood. It is estimated that about 376 million people had genital HSV-1 infections in 2020. Of these, an estimated 50 million also have HSV-2 because it is possible to have both types at the same time.

While estimates for 2020 show virtually no difference in genital HSV-2 prevalence compared to 2016, estimated genital HSV-1 infections are higher. Over recent years, several countries have seen changing patterns of HSV-1 transmission, with genital infections in adults increasing while oral infections in childhood declining. Reduced oral transmission during childhood may be associated with factors such as less crowded living conditions and improved hygiene, which then increase susceptibility to the virus in older age. The authors note that these increases may also partially reflect changes in methods and additional data sources.

“The stigma around genital herpes means it is under-discussed, despite affecting millions of people around the world. “Not enough is being done to address this common infection,” said Dr. Sami Gottlieb, author of the report and medical officer in the WHO Division of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme. Research, Development and Research Training in Human Reproduction (HRP). “Expanded research and investment in the development of new herpes vaccines and therapies, and their equitable use, could play a critical role in improving the quality of life for people around the world.”

Although they are not completely effective in stopping its spread, proper and consistent use of condoms reduces the risk of herpes transmission. People with active symptoms should avoid sexual contact with other people, as herpes is most contagious when sores are present. WHO recommends that people with symptoms of genital herpes be offered HIV testing and, if necessary, pre-exposure prophylaxis to prevent HIV.

In line with your own Global Health Sector Strategy on HIV, Viral Hepatitis and Sexually Transmitted Infections 2022-2030.WHO is working to increase awareness of genital herpes infections and related symptoms, improve access to antiviral drugs, and promote related HIV prevention efforts. It is also being worked on improve research and development new tools for the prevention and control of herpes infections, such as vaccines, treatments and topical microbicides.

Earlier this year, a new study showed that genital herpes infections not only cause significant health effects, but also large economic costs—an estimated US$35 billion annually worldwide—through health care expenditures and lost productivity.

Editor's note

study, Estimated Global and Regional Incidence and Prevalence of Herpes Simplex Virus and Genital Ulcer Infections in 2020: A Mathematical Modeling Analysisupdates the estimates of the World Health Organization for 2012 and 2016. It was authored by experts from WHO, HRP, the WHO Collaborating Center for Disease Epidemiology Analytics for HIV/AIDS, sexually transmitted infections and viral hepatitis at Weill Cornell Medicine-Qatar and the University of Bristol.

Based on comprehensive regional systematic reviews and meta-analyses of HSV-1 and HSV-2 prevalence for all regions of the World Health Organization, the study estimates the prevalence and incidence of genital HSV infection and HSV-related genital ulceration in 2020 globally and by region.