P164 The epidemiology of herpes simplex virus type 2 in Asia: a systematic review, meta-analyses, and meta-regressions

Background Herpes simplex virus type 2 (HSV-2) infection is a prevalent sexually transmitted infection worldwide. This systematic review aimed at characterizing HSV-2 epidemiology in Asia. Methods HSV-2 publications were systematically reviewed. Findings were reported according to PRIMA guidelines. Pooled measures and associations were assessed using random-effect meta-analyses and meta-regressions. Results From 173 relevant publications, 340 overall outcome measures and 729 stratified measures were extracted. Pooled mean HSV-2 seroprevalence was 12.1% (95% confidence interval (CI): 11.0–13.2%) among general populations, 23.6% (95% CI: 20.9–26.3%) among men who have sex with men and transgender people, 46.0% (95% CI: 39.2–52.9%) among HIV positive individuals and individuals in HIV discordant couples, and 62.2% (95% CI: 58.9–65.6%) among female sex workers. Among general populations, pooled mean seroprevalence increased gradually from 4.7% (95% CI: 3.3–6.3%) in 60 years-old individuals. Compared to women, men had a 0.60 (95% CI: 54.0–67.0) lower seroprevalence. Seroprevalence declined by 0.98-fold (95% CI: 0.97–0.99) per year in the last three decades. Pooled mean proportions of HSV-2 detection in genital ulcer disease (GUD) and in genital herpes were 48.2% (95% CI: 34.9–61.6%) and 75.9% (95% CI: 68.3–82.8%), respectively. Conclusion In Asia, approximately 1 in 10 individuals is infected with HSV-2, but seroprevalence is declining by 2% per year. HSV-2 persists as the cause of nearly 50% of GUD cases and 75% of genital herpes cases.