<br>单纯疱疹病毒引起的生殖器溃疡病的全球和区域负担：自然历史模型研究,BMJ Global Health

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单纯疱疹病毒引起的生殖器溃疡病的全球和区域负担：自然历史模型研究
BMJ Global Health ( IF 7.1 ) Pub Date : 2020-03-01 , DOI: 10.1136/bmjgh-2019-001875
Katharine Jane Looker ₁ , Christine Johnston _{2,

3,

4} , Nicky J Welton ₁ , Charlotte James ₁ , Peter Vickerman ₁ , Katherine M E Turner ₅ , Marie-Claude Boily ₆ , Sami L Gottlieb ₇

Affiliation

简介单纯疱疹病毒 (HSV) 感染可引起疼痛、复发性生殖器溃疡病 (GUD)，对性健康和生殖健康产生重大影响。 HSV 相关的 GUD 最常由 2 型 HSV (HSV-2) 引起，但也可能由 1 型生殖器 HSV (HSV-1) 引起，与 HSV-2 相比，其复发频率较低。 GUD 的全球负担从未被量化。在这里，我们首次对 15-49 岁女性和男性中由 HSV-1 和 HSV-2 引起的 GUD 进行全球和区域估计。方法我们通过文献检索模型参数数据，开发了反映 HSV-2 和生殖器 HSV-1 感染后 GUD 临床病程的自然史模型。我们考虑了已诊断和未诊断的有症状感染。然后将该模型应用于现有的感染估计和 2016 年人口规模。根据不同的假设进行了敏感性分析。结果我们估计，2016 年全球有 1.87 亿 15-49 岁的人至少患有一次 HSV 相关 GUD：占世界人口的 5.0%。其中，1.78 亿人（其中 95% 患有 HSV 相关 GUD）患有 HSV-2，而 900 万人（5%）患有 HSV-1。非洲的 GUD 负担最高，女性大约是男性的两倍。 2016 年，全球估计有 80 亿人/天感染 HSV 相关 GUD，其中 99% 的天数感染 HSV-2。考虑到参数不确定性，至少发生过一次 HSV 相关 GUD 的百分比范围为 3.2% 至 7.9%（1.20-2.96 亿）。然而，估计对模型假设很敏感。结论我们的研究是量化 HSV 相关 GUD 的全球负担的首次尝试，该负担很大。 HSV 疫苗、抗病毒药物或杀菌剂等新干预措施有可能改善全世界数百万人的生活质量。

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The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study

Introduction Herpes simplex virus (HSV) infection can cause painful, recurrent genital ulcer disease (GUD), which can have a substantial impact on sexual and reproductive health. HSV-related GUD is most often due to HSV type 2 (HSV-2), but may also be due to genital HSV type 1 (HSV-1), which has less frequent recurrent episodes than HSV-2. The global burden of GUD has never been quantified. Here we present the first global and regional estimates of GUD due to HSV-1 and HSV-2 among women and men aged 15–49 years old. Methods We developed a natural history model reflecting the clinical course of GUD following HSV-2 and genital HSV-1 infection, informed by a literature search for data on model parameters. We considered both diagnosed and undiagnosed symptomatic infection. This model was then applied to existing infection estimates and population sizes for 2016. A sensitivity analysis was carried out varying the assumptions made. Results We estimated that 187 million people aged 15–49 years had at least one episode of HSV-related GUD globally in 2016: 5.0% of the world’s population. Of these, 178 million (95% of those with HSV-related GUD) had HSV-2 compared with 9 million (5%) with HSV-1. GUD burden was highest in Africa, and approximately double in women compared with men. Altogether there were an estimated 8 billion person-days spent with HSV-related GUD globally in 2016, with 99% of days due to HSV-2. Taking into account parameter uncertainty, the percentage with at least one episode of HSV-related GUD ranged from 3.2% to 7.9% (120–296 million). However, the estimates were sensitive to the model assumptions. Conclusion Our study represents a first attempt to quantify the global burden of HSV-related GUD, which is large. New interventions such as HSV vaccines, antivirals or microbicides have the potential to improve the quality of life of millions of people worldwide.

更新日期：2020-03-01

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