P070 Epidemiology of herpes simplex virus type 2 in Latin America and the Caribbean: systematic review, meta-analyses, and meta-regressions

Abstract

<h3>Background</h3> Herpes simplex virus type 2 (HSV-2) infection is a sexually transmitted infection of global concern. This study aims to characterize epidemiology of herpes simplex virus type 2 (HSV-2) in Latin America and the Caribbean. <h3>Methods</h3> HSV-2 reports were systematically reviewed and synthesized, and findings were reported following PRISMA guidelines. Meta-analyses and meta-regressions were conducted. <h3>Results</h3> 102 relevant reports were identified including 13 overall incidence measures, 163 overall (and 402 stratified) seroprevalence measures, and 7 and 10 proportions of virus detection in genital ulcer disease (GUD) and in genital herpes, respectively. Pooled mean seroprevalence was 20.6% (95% confidence interval (CI): 18.7–22.5%) in general populations, 33.3% (95% CI: 26.0–41.0%) in intermediate-risk populations, 74.8% (95% CI: 70.6–78.8%) in female sex workers, and 54.6% (95% CI: 47.4–61.7%) in male sex workers, men who have sex with men, and transgender people. In general populations, seroprevalence increased from 9.6% (95% CI: 7.1–12.4%) in those aged &lt;20 years, to 17.9% (95% CI: 13.6–22.5%) in those 20–30, 27.6% (95% CI: 21.4–34.2%) in those 30–40, and 38.4% (95% CI: 32.8–44.2%) in those &gt;40. Compared to women, men had lower seroprevalence with an adjusted relative risk (ARR) of 0.68 (95% CI: 0.60–0.76). Seroprevalence declined by 2% per year over the last three decades [ARR of 0.98 (95% CI: 0.97–0.99)]. Pooled mean proportions of HSV-2 detection in GUD and genital herpes were 41.4% (95% CI: 18.9–67.0%) and 91.1% (95% CI: 82.7–97.2%), respectively. <h3>Conclusion</h3> One in five adults is HSV-2 infected, a higher level than other world regions, but seroprevalence is declining. Despite this decline, HSV-2 persists as the etiological cause of nearly half of GUD cases and almost all of genital herpes cases.