title: Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012.
abstract: BACKGROUND
  Herpes simplex virus type 2 (HSV-2) infection causes significant disease globally. Adolescent and adult infection may present as painful genital ulcers. Neonatal infection has high morbidity and mortality. Additionally, HSV-2 likely contributes substantially to the spread of HIV infection. The global burden of HSV-2 infection was last estimated for 2003. Here we present new global estimates for 2012 of the burden of prevalent (existing) and incident (new) HSV-2 infection among females and males aged 15-49 years, using updated methodology to adjust for test performance and estimate by World Health Organization (WHO) region.
  
  
  RESULTS
  We conducted a literature review of HSV-2 prevalence studies world-wide since 2000. We then fitted a model with constant HSV-2 incidence by age to pooled HSV-2 prevalence values by age and sex. Prevalence values were adjusted for test sensitivity and specificity. The model estimated prevalence and incidence by sex for each WHO region to obtain global burden estimates. Uncertainty bounds were computed by refitting the model to reflect the variation in the underlying prevalence data. In 2012, we estimate that there were 417 million people aged 15-49 years (range: 274-678 million) living with HSV-2 infection world-wide (11.3% global prevalence), of whom 267 million were women. We also estimate that in 2012, 19.2 million (range: 13.0-28.6 million) individuals aged 15-49 years were newly-infected (0.5% of all individuals globally). The highest burden was in Africa. However, despite lower prevalence, South-East Asia and Western Pacific regions also contributed large numbers to the global totals because of large population sizes.
  
  
  CONCLUSIONS
  The global burden of HSV-2 infection is large, leaving over 400 million people at increased risk of genital ulcer disease, HIV acquisition, and transmission of HSV-2 to partners or neonates. These estimates highlight the critical need for development of vaccines, microbicides, and other new HSV prevention strategies.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Katharine J
authors.initials: KJ
authors.lastname: Looker
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America.
authors.forename: Amalia S
authors.initials: AS
authors.lastname: Magaret
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Katherine M E
authors.initials: KM
authors.lastname: Turner
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Vickerman
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Sami L
authors.initials: SL
authors.lastname: Gottlieb
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D018258:Herpesvirus 2, Human; D022283:Herpesvirus Vaccines / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015995:Prevalence; D035501:Uncertainty
chemical_list: D022283:Herpesvirus Vaccines