Table 1.
Pooled mean estimates for HSV-2 seroprevalence among different at-risk populations in Europe by sex.
| Population type | Outcome measures |
Sample size |
HSV-2 seroprevalence (%) |
Pooled mean HSV-2 seroprevalence |
Heterogeneity measures |
|||
|---|---|---|---|---|---|---|---|---|
| Total n |
Total N |
Range | Median | Mean (%) (95% CI) |
Qa (p-value) | I2b (%) (95% CI) |
Prediction intervalc (%) | |
| General populations | 626 | 154,957 | 0.0–95.0 | 11.3 | 12.4 (11.5–13.3) | 13127.0 (p < 0.001) | 95.2 (95.0–95.5) | 0.0–38.8 |
| Women | 359 | 88,907 | 0.0–85.7 | 12.5 | 14.0 (12.8–15.3) | 7690.7 (p < 0.001) | 95.3 (95.0–95.6) | 0.2–41.8 |
| Men | 186 | 38,478 | 0.0–40.8 | 8.5 | 8.2 (7.2–9.2) | 2272.7 (p < 0.001) | 91.9 (91.0–92.6) | 0.1–24.9 |
| Mixed | 81 | 27,572 | 0.0–95.0 | 14.7 | 15.8 (12.8–19.2) | 1964.4 (p < 0.001) | 95.9 (95.4–96.4) | 0.0–50.4 |
| Intermediate-risk populationsd | 12 | 3119 | 2.0–32.8 | 11.9 | 12.3 (7.3–18.4) | 241.4 (p < 0.001) | 95.4 (93.5–96.8) | 0.0–40.7 |
| Womene | 1 | 67 | - | - | 9.0 (3.4–18.5) | - | - | - |
| Men | 6 | 1558 | 8.1–28.1 | 17.1 | 17.0 (11.5–23.3) | 41.8 (p < 0.001) | 88.0 (76.4–93.9) | 2.1–41.4 |
| Mixed | 5 | 1494 | 2.0–32.9 | 5.1 | 8.2 (1.6–19.1) | 93.7 (p < 0.001) | 95.7 (92.5–97.6) | 0.0–63.5 |
| Higher-risk populations | 28 | 9058 | 5.9–89.3 | 50.7 | 47.2 (37.6–57.0) | 2276.4 (p < 0.001) | 98.8 (98.6–99.0) | 4.4–93.0 |
| FSWs | 16 | 2047 | 33.3–89.3 | 59.6 | 63.2 (55.5–70.6) | 149.4 (p < 0.001) | 90.0 (85.3–93.1) | 30.7–90.3 |
| MSM | 12 | 7011 | 5.9–56.0 | 34.5 | 27.8 (17.5–39.4) | 1177.8 (p < 0.001) | 99.1 (98.8–99.2) | 0.2–75.8 |
| STI clinic attendees and symptomatic populationsf | 74 | 19,487 | 2.0–84.9 | 25.0 | 26.9 (23.1–30.8) | 1725.8 (p < 0.001) | 95.8 (95.2–96.3) | 2.8–62.8 |
| Women | 29 | 6136 | 4.8–60.0 | 23.0 | 25.5 (20.8–30.5) | 422.5 (p < 0.001) | 93.4 (91.5–94.8) | 5.0–54.5 |
| Men | 21 | 6144 | 2.0–35.0 | 18.5 | 17.4 (13.6–21.6) | 340.4 (p < 0.001) | 94.1 (92.2–95.6) | 3.2–39.3 |
| Mixed | 24 | 7207 | 8.0–84.9 | 31.0 | 38.3 (29.9–47.0) | 667.8 (p < 0.001) | 96.6 (95.7–97.2) | 4.2–81.2 |
| People living with HIV and people in HIV discordant couples | 35 | 3660 | 9.0–94.0 | 43.9 | 46.0 (40.1–51.8) | 386.3 (p < 0.001) | 91.2 (88.8–93.1) | 15.0–78.8 |
| Women | 12 | 784 | 17.4–94.0 | 56.5 | 55.3 (41.4–68.8) | 138.3 (p < 0.001) | 92.0 (88.0–94.7) | 7.8–97.1 |
| Men | 9 | 1370 | 31.0–62.0 | 50.0 | 46.4 (39.5–53.3) | 64.9 (p < 0.001) | 87.7 (78.7–92.9) | 24.1–69.5 |
| Mixed | 14 | 1506 | 9.0–59.6 | 39.6 | 38.5 (31.7–45.5) | 126.0 (p < 0.001) | 89.7 (84.5–93.1) | 14.3–66.1 |
| Infertility clinic attendees and women with ectopic pregnancies | 7 | 766 | 2.0–24.0 | 12.0 | 11.7 (5.8–19.2) | 49.8 (p < 0.001) | 87.9 (77.5–93.5) | 0.0–43.0 |
| Women | 7 | 766 | 2.0–24.0 | 12.0 | 11.7 (5.8–19.2) | 49.8 (p < 0.001) | 87.9 (77.5–93.5) | 0.0–43.0 |
| Other populations | 31 | 27,929 | 6.7–44.4 | 17.5 | 21.2 (17.4–25.2) | 508.0 (p < 0.001) | 94.1 (92.6–95.3) | 4.4–45.7 |
| Women | 13 | 2052 | 11.4–42.1 | 16.7 | 20.1 (15.4–25.3) | 93.3 (p < 0.001) | 87.1 (79.8–91.8) | 5.2–41.2 |
| Men | 4 | 535 | 6.7–44.4 | 24.6 | 23.1 (7.8–43.4) | 78.8 (p < 0.001) | 96.2 (92.9–98.0) | 0.0–100 |
| Mixed | 14 | 25,342 | 9.3–43.9 | 21.8 | 21.8 (16.1–28.0) | 296.5 (p < 0.001) | 95.6 (94.0–96.8) | 3.4–49.5 |
Abbreviations: CI = Confidence interval, FSWs = Female sex workers, HIV = Human immunodeficiency virus, HSV-2 = Herpes simplex virus type 2, MSM = Men who have sex with men, STI = Sexually transmitted infection.
Q: The Cochran's Q statistic is a measure assessing the existence of heterogeneity in seroprevalence.
I2: A measure that assesses the magnitude of between-study variation that is due to actual differences in seroprevalence across studies, rather than sampling variation.
Prediction interval: A measure that estimates the distribution (95% interval) of true seroprevalence around the estimated mean.
Intermediate-risk populations include populations who presumably have frequent sexual contacts with populations engaging in high sexual risk behaviour and have therefore a higher risk of exposure to HSV-2 than the general population. These comprise prisoners, people who inject drugs, and truck drivers, among others.
No meta-analysis was conducted due to the small number of studies (n < 3).
Symptomatic populations include patients with STI clinical manifestations.