Introduction
Herpes simplex virus type 2 (HSV-2) is an incurable and recurring
sexually transmitted infection.1 Often asymptomatic,
people with HSV-2 can transmit the virus to their sexual partners
without awareness of their infection.2 It also
increases the risk of acquiring and transmitting the Human
immunodeficiency virus (HIV).3,4 Given its contingency
and impact on life quality and well-being,5understanding the epidemiology of HSV-2 is essential for informing
future prevention. Also, considering its synergy with HIV, reducing
HSV-2 infection is beneficial to the goal of ending STI epidemics as
major public health concerns by 2030.6
The latest estimate of HSV-2 global prevalence in 2016 was 13.2% (491
million) among people aged 15-49 worldwide.7 Recent
meta-reviews have reported a wide range of prevalence estimates from
different geographical regions, including 37.3% in sub-Saharan
Africa,8 20.6% in Latin America,915.4% in Canada, Australia, and New Zealand,10 12.4%
in Europe,11 12.1% in Asia,12 and
5.1% in the Middle East and North Africa among the general
population.13 Seroprevalences of HSV-2 among key
populations such as male sex workers(MSW), men who have sex with men
(MSM), and female sex workers (FSW) are substantially higher across
regions, ranging from 20.6% to 74.8% for FSW and from 18.3% to 54.6%
for MSM and MSW.8-13
Despite the existing literature, a comprehensive overview of HSV-2
epidemiology and trends among different populations in China is limited,
calling for a systematic review and meta-analysis. A meta-analysis in
Asia reported a pooled HSV-2 seroprevalence of 9.3% among the general
population.12 However, it only included literature
identified from English bibliographic databases, which may incur
language bias.14 We also identified two additional
meta-analyses that focused on specific populations in China, such as the
MSM population with a pooled prevalence of 9.4%, 15and the FSW population with a 15.8% HSV-2
prevalence.16 These reviews included a small portion
of the existing studies, which is quite limited. Our study aims to fill
this gap and provide a more comprehensive and up-to-date estimate of the
HSV-2-related outcomes (e.g., prevalence and incidence) among various
populations in China by synthesizing literature published in Chinese and
English and generating estimates by different groups and subpopulations.