According to a recent study, high-income and upper-middle-income nations sustained the highest economic burden from herpes infections in 2016, accounting for more than 75 per cent of the global spending.
The infection was responsible for $11·9 billion in healthcare expenditures 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 study published in BMC Global and Public Health noted.
“This is likely due to higher proportions of individuals seeking care, higher utilisation of diagnostic tests, and higher therapy costs, compared to other regions,” the paper mentioned.
However, the magnitude of the economic burden and the incidence of the disease burden did not match. For example, the number of people with genital herpes was the highest in Africa — 59 million.
However, the number of individuals estimated to be seeking and receiving care was relatively smaller compared to more developed parts of the world.
Herpes is caused by an infection with one of two types of Herpes simplex virus (HSV). While HSV-1 mostly spreads by oral contact and causes infections in or around the mouth in children, it can also cause genital herpes in adults who have not been infected in childhood. HSV-2 spreads by sexual contact and causes genital herpes.
Around 67 per cent of the global population aged 0-49 have HSV-1 and approximately 13 per cent aged 15–49 years are living with HSV-2 infection. The latter can almost triple the risk of sexually acquired HIV infections.
The study calls for the development of safe and efficacious vaccines. “Currently available HSV interventions, such as antiviral drugs, can reduce symptoms but cannot cure or prevent transmission on a population level,” the paper read.
An assessment of the economic burden of HSV, it added, is an important step toward supporting the public health value assessment for HSV vaccine development. However, there is a poor understanding of the global economic impact of herpes infection – until now, according to the research.
So, experts from multiple institutions and the World Health Organization (WHO) estimated the global economic burden based on published estimates of HSV disease outcomes for the year 2016 for each of the 194 countries in all six WHO regions.
Globally, the estimated economic burden of genital HSV infection and its consequences in 2016 was $35·3 billion. Of this, $31·2 billion (88 per cent) was associated with Type 2 (HSV-2) and $4·0 billion with Type I (HSV-1).
By WHO regions, genital herpes due to HSV-2 was responsible for $3·4 billion in the African region, $6·5 billion in the Americas region, 1·7 billion in the Eastern Mediterranean region, $4·0 billion in the Europe region, $3·9 billion in the Southeast Asia region, and $11·3 billion in the Western Pacific region.
As for HSV-1, it was responsible for $2·0 billion in the Americas region, $0·2 billion in the Eastern Mediterranean region, $0·9 billion in the Europe region, $0·02 billion in the South-East Asia region, and $0·9 billion in the Western Pacific region.
The team broke down the costs as well. Direct medical costs were responsible for 62 per cent of the total costs associated with HSV infection, followed by indirect costs and direct non-medical costs, contributing 35 per cent and 2.8 per cent, respectively.
“As people with HSV-2 infection are more vulnerable to contracting HIV infection, a vaccine against HSV may also be useful in reducing HIV incidence,” the study said, adding that this is particularly important in the African region, which has a high prevalence of the disease. HIV attributable to HSV-2 infection contributed around 10 per cent of the total economic burden of HSV in the region.
The researchers acknowledge a few limitations in their study. For example, they omitted costs associated with non-genital HSV outcomes along with the lifetime disease burden and treatment costs as well as changes in treatment-seeking behaviour.
