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  • Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: mathematical modelling analyses

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Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: mathematical modelling analyses
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  • Published on: 19 May 2025
    Response to Comment

    We sincerely thank the reader for their interest in our article and for drawing attention to the important issue of HSV infections among people living with HIV (PLHIV). We fully agree that the epidemiology of HSV-1 and HSV-2 infections can differ markedly between PLHIV and the general population, and that coinfection—particularly the interplay between HSV-2 and HIV—has important clinical and public health implications, including for HIV acquisition, transmission, and disease progression. These interactions have been a major focus of our prior work and have been addressed extensively in numerous previous publications.
    The present study was designed with a specific scope: to generate global and regional estimates of HSV-1 and HSV-2 infections in the total population, using the best available epidemiological data. Unfortunately, the global data landscape remains too limited to support robust modeling of HSV infections specifically among PLHIV or other key subpopulations. In particular, population-level data disaggregated by HIV status are lacking across most regions of the world.
    In summary, the absence of HIV-specific estimates in this analysis does not reflect a lack of recognition of their importance. On the contrary, we have addressed HSV–HIV interactions in earlier studies and remain committed to investigating these important dynamics in future research.

    Professor Laith Abu-Raddad, Ph.D.
    Weill Cornell Medicine – Qatar
    Cornell University...

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    Conflict of Interest:
    None declared.
  • Published on: 19 May 2025
    Incidence and prevalence of Herpes simplex virus 1 and 2 and genital ulcer disease (GUD)
    • Prof Sarman Singh, Director Aarupadai Veedu Medical College & Hospital, Vinayaka Mission's Research Foundation (Deemed University), Pondicherry, India

    I read with great interest a recently published article by Harfouche et al, in the STI.1 The authors have used mathematical modelling to estimate the global and regional burden of Herpes simplex virus -1 (HSV-1) and Herpes simplex virus-2 (HSV-2). I find a serious concern that authors have not provided any information about or proposed model to estimate the incidence and prevalence of HSV-1 and HSV-2 in people living with HIV. This information, and model if any, would be very crucial; as the prevalence and incidence of these viruses especially that of HSV-2, varies significantly in people living with HIV as compared to in those who are living without HIV.2 Not only incidence and prevalence of HSV-2 is different in these two populations but the coinfection of these viruses has important role in HIV pathogenesis and AIDS disease progression. In a recent study we reported that overall prevalence of HSV-1 in Indian adult males was 75.2%. Of these, 68.18% were males living with HIV. The prevalence of HSV-1 in people living with HIV was 77.2% and 71.2% in males without HIV. The difference was not statistically significant. The prevalence increased with age, from 60% in males aged <25 years to 86% in older subjects (P = 0.0188). The overall prevalence of HSV-2 was 28.20% in Indian males. However, the prevalence of HSV-2 in people living with HIV was 39.9% while in males without HIV, it was only 5.1%. The prevalence of HSV-2 in patients living with HIV increased with age, f...

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    Conflict of Interest:
    None declared.