Table 4.
Pooled proportions of herpes simplex virus type 1 virus isolation in clinically diagnosed genital ulcer disease and in clinically diagnosed genital herpes in Europe
| Population | Outcome measure | Sample | Proportion of HSV-1 detection | Pooled proportion of HSV-1 detection | Heterogeneity measures | |||
| Total N | Total N |
Range | Median | Mean (95% CI) |
Q* (p-value) |
I²† (%) (95% CI) |
Prediction interval‡ (%) | |
| Patients with clinically diagnosed GUD | ||||||||
| All patients with GUD | 4 | 800 | 4.7–39.8 | 8.5 | 13.6 (4.1 to 27.1) | 58.1 (p<0.001) | 94.8 (89.0 to 97.4) | 0.0–85.5 |
| Patients with clinically diagnosed genital herpes | ||||||||
| Sex | ||||||||
| Women | 62 | 4933 | 6.0–89.6 | 43.5 | 42.0 (37.4 to 46.7) | 615.3 (p<0.001) | 90.2 (88.0 to 91.8) | 11.6–76.0 |
| Men | 56 | 3578 | 0.0–75.0 | 26.6 | 24.1 (19.8 to 28.6) | 461.1 (p<0.001) | 88.1 (85.3 to 90.3) | 1.8–58.4 |
| Mixed | 44 | 32 570 | 4.6–81.8 | 45.0 | 35.8 (32.1 to 39.6) | 1778.5 (p<0.001) | 97.6 (97.2 to 97.9) | 14.7–60.3 |
| Age group (years) | ||||||||
| <20 | 3 | 157 | 45.4–66.6 | 53.3 | 52.1 (39.1 to 64.9) | 3.2 (p=0.197) | 38.5 (0.0 to 80.8) | 0.0–100 |
| 20–30 | 6 | 643 | 27.3–54.9 | 38.5 | 39.9 (32.2 to 47.8) | 18.3 (p=0.003) | 72.7 (37.1 to 88.1) | 17.1–65.2 |
| 30–40 | 2§ | 102 | 34.0–51.8 | 43.3 | 43.5 (27.4 to 60.3)§ | – | – | – |
| Mixed | 151 | 40 179 | 0.0–89.6 | 33.3 | 33.4 (30.9 to 39.6) | 3497.8 (p<0.001) | 95.7 (95.3 to 96.1) | 9.5–62.8 |
| Genital herpes episode status | ||||||||
| First episode genital herpes | 13 | 1366 | 31.0–75.0 | 49.0 | 49.3 (42.2 to 56.4) | 66.1 (p<0.001) | 81.8 (70.1 to 89.0) | 24.5–74.2 |
| Recurrent genital herpes | 11 | 893 | 1.0–77.3 | 10.0 | 13.7 (5.8 to 24.1) | 152.7 (p<0.001) | 92.5 (90.2 to 95.6) | 0.060.5 |
| Unspecified status | 138 | 38 822 | 0.0–89.6 | 34.7 | 34.7 (32.3 to 37.1) | 2730.0 (p<0.001) | 95.0 (94.4 to 95.5) | 12.3–61.2 |
| European subregion/country | ||||||||
| Northern Europe | 131 | 38 843 | 1.0–89.6 | 34.8 | 35.0 (32.5 to 37.6) | 2854.7 (p<0.001) | 95.4 (95.0 to 95.9) | 12.1–62.2 |
| Eastern Europe | 2§ | 100 | 34.9–63.1 | 49.0 | 49.3 (22.7 to 76.0)§ | – | – | – |
| Southern Europe | 8 | 286 | 0.0–50.0 | 15.4 | 18.2 (7.3 to 23.1) | 39.1 (p<0.001) | 82.1 (66.0 to 90.6) | 0.0–68.9 |
| Western Europe | 5 | 462 | 7.5–37.1 | 25.0 | 21.8 (11.7 to 33.8) | 33.2 (p<0.001) | 88.0 (74.4 to 94.3) | 0.0–70.2 |
| Israel | 4 | 605 | 21.0–72.7 | 54.0 | 50.3 (20.8 to 79.7) | 142.4 (p<0.001) | 97.9 (96.5 to 98.7) | 0.0–100 |
| Mixed subregions | 12 | 785 | 6.0–57.5 | 37.9 | 30.8 (19.5 to 43.4) | 140.4 (p<0.001) | 92.2 (88.2 to 94.8) | 0.0–79.5 |
| Year or publication range | ||||||||
| <2000 | 74 | 5072 | 0.0–81.8 | 34.8 | 33.4 (28.3 to 38.8) | 1099.7 (p<0.001) | 93.4 (92.3 to 94.3) | 1.7–78.1 |
| 2000–2010 | 53 | 8727 | 4.0–77.3 | 25.0 | 29.4 (24.6 to 34.5) | 1196.4 (p<0.001) | 95.7 (94.9 to 96.3) | 3.0–67.1 |
| >2010 | 35 | 27 282 | 18.7–89.6 | 42.8 | 46.0 (43.6 to 48.3) | 280.0 (p<0.001) | 87.9 (84.1 to 90.7) | 35.6–56.5 |
| All patients with genital herpes | 162 | 41 081 | 0.0–89.7 | 34.7 | 34.1 (31.7 to 36.5) | 3529.8 (p<0.001) | 95.4 (95.0 to 95.8) | 10.1–63.2 |
*The Cochran’s Q statistic is a measure assessing the existence of heterogeneity in pooled outcome measures (here, proportions of HSV-1 virus isolation).
†I2 is a measure assessing the magnitude of between study variation that is due to true differences in proportions of HSV-1 virus isolation across studies rather than sampling variation.
‡Prediction interval is a measure quantifying the 95% interval of the distribution of true proportions of HSV-1 virus isolation around the estimated pooled mean.
§No meta-analysis was done as number of studies was <3. The two study samples were merged to yield one sample size, for which the 95% CI was calculated.
GUD, genital ulcer disease; HSV-1, herpes simplex virus type 1.