Recent estimates indicate that approximately 846 million people between the ages of 15 and 49 are living with genital herpes infections globally—representing more than 1 in 5 individuals in this age group. Alarmingly, 42 million people are estimated to acquire a new genital herpes infection annually, or at least one person every second.
Although most individuals with genital herpes experience minimal symptoms, the infection can lead to recurrent, painful genital sores and blisters for some, which may necessitate frequent medical visits. In 2020 alone, more than 200 million people aged 15 to 49 suffered at least one symptomatic episode. The World Health Organization (WHO) and the authors of the study, published in Sexually Transmitted Infections, emphasize the urgent need for new treatments and vaccines to alleviate the health consequences of herpes infections and limit their spread.
Genital Herpes: A Global Health Challenge
Dr. Meg Doherty, WHO’s Director of Global HIV, Hepatitis, and Sexually Transmitted Infections Programmes, noted that while many individuals with genital herpes experience few symptoms, the widespread nature of the infection still leads to significant pain, distress, and additional strain on already overburdened health systems. Effective prevention and treatment options are critical to reduce the transmission of herpes, which, in turn, can help curb the transmission of HIV.
Currently, there is no cure for herpes, though available treatments can alleviate symptoms. Beyond painful sores, genital herpes can lead to serious complications, including neonatal herpes, a rare but severe condition that occurs when a mother acquires the infection late in pregnancy and transmits it to her baby during childbirth.
The Two Types of Herpes Simplex Virus (HSV)
There are two types of herpes simplex virus (HSV), HSV-1 and HSV-2, both of which can lead to genital herpes. In 2020, approximately 520 million people had genital HSV-2, which is predominantly transmitted through sexual activity. Genital HSV-2 is considered more serious from a public health perspective, as it is more likely to cause recurrent outbreaks, accounts for about 90% of symptomatic episodes, and significantly increases the risk of HIV transmission (by up to three times).
On the other hand, HSV-1 primarily spreads through saliva or skin-to-skin contact around the mouth, causing oral herpes. Cold sores or mouth ulcers are common symptoms of oral herpes. However, HSV-1 can also be transmitted sexually and cause genital herpes, particularly in individuals who have not previously been infected. Approximately 376 million people had genital HSV-1 infections in 2020, with around 50 million individuals estimated to have both HSV-1 and HSV-2.
Changing Patterns of HSV-1 Transmission
Interestingly, the prevalence of genital HSV-1 infections has increased in recent years, while childhood oral infections have declined in some countries. This shift may be linked to factors such as improved hygiene and less crowded living conditions, which reduce the likelihood of contracting oral HSV-1 at a young age. However, these same factors may increase susceptibility to genital HSV-1 infection later in life.
Although these trends partly reflect changes in diagnostic methods and data sources, they underscore the need for continued research into herpes transmission patterns and public health strategies.
Addressing Stigma and the Need for New Solutions
Dr. Sami Gottlieb, a medical officer at WHO, highlighted the stigma surrounding genital herpes as a significant barrier to addressing the infection. Despite its widespread impact, herpes has not been adequately discussed or addressed globally. Greater research investment is needed to develop new herpes vaccines and therapies, ensuring equitable access for individuals affected worldwide.
While condoms offer some protection against herpes transmission, they are not fully effective. Consistent and correct use of condoms can reduce the risk, but those with active symptoms should avoid sexual contact to prevent spreading the virus. WHO recommends that individuals with genital herpes symptoms be tested for HIV and, if necessary, receive pre-exposure prophylaxis (PrEP) for HIV prevention.
Economic and Health Impacts
In addition to the health burden of herpes infections, they also result in significant economic costs, estimated at US $35 billion annually worldwide. These costs are driven by healthcare expenditures and lost productivity, further highlighting the importance of improved prevention, treatment, and research into herpes management.
WHO’s Efforts and Global Health Strategy
Aligned with its Global Health Sector Strategy on HIV, viral hepatitis, and sexually transmitted infections for 2022-2030, WHO is working to increase awareness of genital herpes infections, improve access to antiviral medications, and promote HIV prevention strategies. The organization is also focusing on advancing research to develop new tools for herpes prevention and control, including vaccines, treatments, and topical microbicides.
In conclusion, the burden of herpes infections worldwide remains substantial. With millions affected and the ongoing challenges of transmission and stigma, there is an urgent need for comprehensive research, novel therapies, and improved global health policies to reduce the impact of genital herpes and prevent further spread.
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