Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence

1. Herpes simplex virus type 2 (HSV-2) infections significantly contribute to the global burden of sexually-acquired HIV infections.

Evidence Rating Level: 2 (Good)

There is a known strong biological association between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) acquisition, transmissibility, and disease severity. This analysis provides the first global and regional-level analysis of population attributable fractions (PAFs) and incidence of HIV infections attributable to HSV-2 infection, with subgroup analyses for female sex workers (FSWs) and men who have sex with men (MSM). Classic epidemiological statistics of polytomous exposure to estimate global and regional PAF and incident HIV infections by age, sex and timing, with pooled adjusted relative risk estimates from systematic review data were used to analyze the association of HSV-2 infection on HIV acquisition. Analyses revealed that 420,000 (95% CI 317,000 to 546,000; PAF 29.6% [95% CI 22.9 to 37.1]) of 1.4 million sexually-acquired adult HIV infections in 2016 were attributable to HSV-2 infections. The largest contribution of HSV-2 infections was evident in the African region, among women, those aged 25 to 49 years, and those with established HSV-2 infections. Study findings suggest a significant burden of underlying HSV-2 infections in sexually-transmitted HIV acquisition, with the greatest burden of HSV-2 infections in areas where the infection is most prevalent.

Click to read the study in Lancet Infectious Diseases

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