A huge part of the world population lives with herpes infection

The virus that causes genital herpes can expose millions of people to a higher risk of HIV infection

About half a billion people worldwide live with genital herpes, and several billion have oral herpes infection, new estimates show.

The author is staff at the University of Bristol, the World Health Organization (WHO) and Weill Cornell Medical College-Qatar, and has been published in Bulletin of the World Health Organization.
a new study estimates the global prevalence of infection and the incidence of herpes simplex virus type 1 and 2 (HSV-1 and HSV-2) in 2016.

“Herpes infection affects millions of people worldwide and can have far-reaching health effects. We need more investment and commitment to develop better tools for treating and preventing this infection. “says Dr. Sami Gottlieb, MD
Officer at WHO and author of the study.

Prevalence and incidence

It is estimated that in 2016, 491.5 million people lived with HSV-2 infection, which is 13.2% of the world’s population aged 15-49. HSV-2 is almost exclusively transmitted sexually, causing infection in the genital or anal area (genital)
herpes).

An estimated 3.7 billion people have had HSV-1 infection during the same year – about 66.6% of the world’s population aged 0-49. HSV-1 is mainly transmitted orally and orally to cause infection in or around the mouth (oral herpes).
HSV-1 can also be transmitted to the genital area by oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 and 192 million people had genitals
HSV-1 infection, depending on the assumptions used in the assessment model.

Because herpes is a lifelong infection, the estimated prevalence has increased with age; The prevalence of HSV-2 was also higher among women and in the WHO African region.

Health and social impacts

Most people living with herpes caused by either HSV-1 or 2 are not aware that they have the infection.

When symptoms occur, oral herpes infection can lead to painful sores around the mouth (“sores”). Genital herpes infection can cause recurrent, often painful, genital ulcers, often referred to as genital ulcers.

The WHO and partners published a study in March 2020 that estimated that about 5% of the world population (187 million people) suffered from at least one episode of genital ulcer for herpes in 2016 (1). Most of these episodes were due to
HSV-2, which can be repeated frequently over many years.

Recurrent genital herpes symptoms can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, over time, most people with herpes adjust to living with the infection.

“Genital herpes in the world is an essential health concern – apart from the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound impact on sexual and reproductive health.”
says Dr. Ian Askew, director of the WHO Department of Sexual and Reproductive Health and Research.

Herpes and HIV

There is a strong correlation between HSV-2 infection and HIV infection. The WHO commissioned a modeling study in 2019 to evaluate how much HSV-2 infection can contribute to HIV incidence. The study estimated that nearly 30% of new sexually acquired HIV was HIV
infections in 2016 worldwide are probably attributable to infection with HSV-2 (2).

Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV if exposed. HSV-2 leads to inflammation and small cracks in the genital and anal skin, which can help HIV to cause infection.
In addition, people with HIV and HSV-2 infection are more likely to spread HIV to others.

Women are more susceptible to both HSV-2 and HIV. Women living in the WHO African region have the highest prevalence of HSV-2 and exposure to HIV – putting them at highest risk of HIV infection, with negative health effects
and well-being.

In people living with HIV (or living with other conditions that threaten their immune system) as well as HSV-2, the symptoms of herpes can be more serious and frequent.

Neonatal herpes

Neonatal herpes can occur when a newborn is exposed to HSV in the genital tract during labor. This is a rare condition, occurs in an estimated 10 out of every 100,000 births worldwide, but can lead to permanent neurological disability or death. Risk
for neonatal herpes, it is greatest when the mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before pregnancy are at very low risk of transmitting HSV to their newborns.

There is no cure – better treatment and prevention is needed

There is no cure for herpes. Currently, antiviral drugs such as acyclovir, famciclovir and valacyclovir can help reduce the severity and frequency of symptoms, but they cannot cure the infection.

With increasing awareness of HSV infection and its symptoms, improved access to antiviral medicines and increased HIV prevention efforts for those with genital HSV symptoms are needed worldwide.

In addition, better treatment and prevention interventions, especially HSV vaccines, are needed. WHO and partners are working to accelerate research to develop new strategies for the prevention and control of HSV infections. Such research includes
development of vaccines against HSV and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

“A vaccine against HSV would not only help promote and protect the health and well-being of millions of people, especially women around the world – it could also have an impact on slowing the spread of HIV if developed.
and it comes together with other HIV prevention strategies, ”says Dr. Meg Doherty, Director, World Health Organization Division of the Global HIV, Hepatitis and STI Program.

Related publications

WHO treatment guidelines Genital herpes Simplex virus

WHO prefers the characteristics of herpes simplex virus vaccine products

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(1) Looker KJ, Johnston C, Welton NJ et al. Global and regional burden of genital ulcer disease due to the herpes simplex virus: a natural history modeling study. BMJ Glob Health. 2020 5 (3): e001875. doi: 10.1136 / bmjgh-2019- 001875.

(2) Looker KJ, Welton NJ, Sabin KM, et al. Global and regional estimates of the contribution of herpes simplex type 2 infection to HIV incidence: analysis of a population fraction used by published epidemiological data. Lancet Infect Dis.
2020 20 (2): 240-249. doi: 10.1016 / S1473-3099 (19) 30470-0.