What is the prevalence of Herpes Simplex Virus type 2 (HSV-2)?

From the Guidelines

Herpes Simplex Virus type 2 (HSV-2) affects approximately 12.1% of the United States population aged 14–49 years, as reported in the most recent study from 2022 1. The prevalence of HSV-2 is a significant concern, as it is a chronic and incurable infection that can cause recurrent genital ulcers and increase the risk of acquiring other sexually transmitted infections, such as HIV.

• Key points to consider:
  • The seroprevalence of HSV-2 in the United States population aged 14–49 years is 12.1% 1.
  • Many individuals with HSV-2 infection are unaware of their status, with only 13% of HSV-2–seropositive persons having been diagnosed with genital herpes 1.
  • Accurate diagnosis of genital herpes can be achieved using type-specific molecular or virologic tests when genital ulcers are present, and type-specific serologic tests to detect antibody when lesions are not present 1.
  • Antiviral medications, such as acyclovir, valacyclovir, or famciclovir, can reduce outbreak frequency and viral shedding, and are particularly important for pregnant women with HSV-2 to prevent transmission to newborns during delivery.
• The importance of regular testing for those at risk and consistent condom use cannot be overstated, as these measures can help reduce transmission, although condoms do not provide complete protection since the virus can be shed from areas not covered by condoms. The most effective way to manage HSV-2 infection is through a combination of antiviral therapy, patient education, and prevention of transmission to sex partners and neonates, as outlined in the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines 1.

From the Research

Prevalence of Herpes Simplex Virus Type 2 (HSV-2)

• The global prevalence of HSV-2 infection is estimated to be around 11.3% among individuals aged 15-49 years, with approximately 417 million people living with the infection worldwide 2.
• In the United States, the seroprevalence of HSV-2 was found to be 16.2% overall, with higher rates among women (20.9%) and non-Hispanic blacks (39.2%) 3.
• The prevalence of HSV-2 infection varies by region, with higher rates in developing countries, particularly in sub-Saharan Africa, where prevalence ranges from 30% to 80% in women and 10% to 50% in men 4.
• A study estimating the global prevalence and incidence of HSV-2 infection in 2003 found that approximately 536 million people aged 15-49 years were living with the infection, with 23.6 million new infections occurring that year 5.
• The seroprevalence of HSV-2 has been increasing over time, with a 30% increase in age-adjusted seroprevalence in the United States between 1976-1980 and 1988-1994 6.

Demographic Factors

• Women are more likely to be infected with HSV-2 than men, with a higher seroprevalence in women (20.9%) compared to men (11.5%) in the United States 3.
• Non-Hispanic blacks have a higher seroprevalence of HSV-2 (39.2%) compared to other racial/ethnic groups in the United States 3.
• The prevalence of HSV-2 infection increases with age, with higher rates among older adults 3, 4.

Global Burden

• HSV-2 infection is a major cause of genital ulcer disease and increases the risk of HIV acquisition 2, 4.
• The global burden of HSV-2 infection is significant, with over 400 million people living with the infection and at increased risk of genital ulcer disease, HIV acquisition, and transmission of HSV-2 to partners or neonates 2.