Herpes Economic Burden in 2016 Highest in Wealthy and Middle-Income Countries: Study

A recent study has found that in 2016, high-income and upper-middle-income countries bore the largest economic burden from herpes infections, making up over 75% of global spending on the disease.

The study, published in BMC Global and Public Health, revealed that herpes infections led to $11.9 billion in healthcare costs and productivity losses in high-income countries, $15.1 billion in upper-middle-income countries, $6.9 billion in lower-middle-income countries, and $1.1 billion in low-income countries.

The paper explained that this disparity is likely because people in wealthier countries are more likely to seek medical care, use diagnostic tests, and pay higher therapy costs compared to those in less developed regions.

Interestingly, the economic burden did not align with the number of herpes cases. For instance, Africa had the highest number of genital herpes cases, with 59 million people affected. However, fewer people in Africa sought and received medical care compared to more developed regions.

Herpes is caused by the Herpes simplex virus (HSV), which comes in two types. HSV-1 usually spreads through oral contact and causes mouth infections in children, but it can also cause genital herpes in adults who were not infected as children. HSV-2 spreads through sexual contact and causes genital herpes.

Globally, about 67% of people aged 0-49 have HSV-1, and around 13% of people aged 15-49 have HSV-2. HSV-2 can nearly triple the risk of getting HIV through sexual contact.

The study emphasized the need for safe and effective vaccines. Current treatments, like antiviral drugs, can reduce symptoms but cannot cure the infection or prevent its spread on a large scale.

Understanding the economic impact of HSV is crucial for supporting the development of vaccines. Until now, there has been limited knowledge about the global economic burden of herpes. To address this, experts from various institutions and the World Health Organization (WHO) estimated the economic burden of HSV for each of the 194 countries in all six WHO regions for the year 2016.

Globally, the economic burden of genital HSV infection and its consequences in 2016 was estimated at $35.3 billion. Of this, $31.2 billion (88%) was due to HSV-2, and $4.0 billion was due to HSV-1.

By WHO regions, HSV-2 caused $3.4 billion in costs in Africa, $6.5 billion in the Americas, $1.7 billion in the Eastern Mediterranean, $4.0 billion in Europe, $3.9 billion in Southeast Asia, and $11.3 billion in the Western Pacific.

For HSV-1, the costs were $2.0 billion in the Americas, $0.2 billion in the Eastern Mediterranean, $0.9 billion in Europe, $0.02 billion in Southeast Asia, and $0.9 billion in the Western Pacific.

The study also broke down the costs: 62% were direct medical costs, 35% were indirect costs, and 2.8% were direct non-medical costs.

The study noted that since people with HSV-2 are more susceptible to HIV, a vaccine for HSV could also help reduce HIV cases, especially in Africa, where the disease is prevalent. In Africa, HIV linked to HSV-2 accounted for about 10% of the total economic burden of HSV.

The researchers acknowledged some limitations in their study, such as not including costs related to non-genital HSV outcomes, lifetime disease burden, treatment costs, and changes in treatment-seeking behavior.