Epidemiology of herpes simplex virus type 1 and genital herpes in Australia and New Zealand: systematic review, meta-analyses and meta-regressions. (8th February 2023)

• Record Type: Journal Article
• Authors: AlMukdad, Sawsan; Harfouche, Manale; Farooqui, Uzma S.; Aldos, Lana; Abu-Raddad, Laith J.
• Is Part Of: Epidemiology and infection. Volume 151(2023)
• Publication Date: 2023-02-08
• Subjects: Australia -- genital ulcer disease -- herpes -- meta-analysis -- meta-regression -- New Zealand -- prevalence; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268823000183
• Languages: English
• ISSNs: 0950-2688

Abstract

Abstract: Herpes simplex virus type 1 (HSV-1) infection is a lifelong infection that is acquired primarily orally and during childhood. We aimed to characterise HSV-1 epidemiology in Australia and New Zealand. HSV-1-related data as recent as 6 December 2021 were systematically reviewed, synthesised and reported, following PRISMA guidelines. Pooled mean seroprevalence and proportions of HSV-1 detection in genital ulcer disease (GUD) and in genital herpes were calculated using random-effects meta-analyses. Meta-regressions were also conducted. HSV-1 measures were retrieved from 21 eligible publications. Extracted HSV-1 measures included 13 overall seroprevalence measures (27 stratified) in Australia, four overall proportions of HSV-1 detection in clinically diagnosed GUD (four stratified) in Australia, and ten overall proportions of HSV-1 detection in laboratory-confirmed genital herpes (26 stratified) in Australia and New Zealand. Pooled mean seroprevalence among healthy adults in Australia was 84.8% (95% confidence interval (CI) 74.3–93.1%). Pooled mean seroprevalence was 70.2% (95% CI 47.4–88.7%) among individuals <35 years of age and 86.9% (95% CI 79.3–93.0%) among individuals ≥35 years. Seroprevalence increased by 1.05-fold (95% CI 1.01–1.10) per year. Pooled mean proportion of HSV-1 detection in GUD was 8.2% (95% CI 0.4–22.9%). Pooled mean proportion of HSV-1 detection in genital herpes was 30.5% (95% CI 23.3–38.3%), and was highest in young individuals. Proportion of HSV-1 detection in genital herpes increased by 1.04-fold (95% CI 1.00–1.08) per year. Included studies showed heterogeneity, but 30% of the heterogeneity in seroprevalence and 42% of the heterogeneity in proportion of HSV-1 detection in genital herpes were explained in terms of epidemiological factors. HSV-1 seroprevalence is higher in Australia than in other Western countries. HSV-1 epidemiology in Australia and New Zealand appears to be transitioning towards less oral acquisition in childhood, but more genital acquisition among youth.