DataSheet_1_Disparities in burden of herpes simplex virus type 2 in China: systematic review, meta-analyses, and meta-regressions.docx

BackgroundThe rising prevalence of herpes simplex type 2 (HSV-2) infection poses a growing global public health challenge. A comprehensive understanding of its epidemiology and burden disparities in China is crucial for informing targeted and effective intervention strategies in the future.
MethodsWe followed Cochrane and PRISMA guidelines for a systematic review and included publications published in Chinese and English bibliographic systems until March 31st, 2024. We synthesized HSV-2 seroprevalence data across different population types. We used random-effects models for meta-analyses and conducted meta-regression to assess the association between population characteristics and seroprevalence.
ResultsOverall, 23,999 articles were identified, and 402 publications (1,203,362 participants) that reported the overall seroprevalence rates (858 stratified measures) were included. Pooled HSV-2 seroprevalence among the general population (lower risk) was 7.7% (95% CI: 6.8-8.7%). Compared to the general population, there is a higher risk of HSV-2 prevalence among intermediate-risk populations (14.8%, 95% CI: 11.0-19.1%), and key populations (31.7%, 95% CI: 27.4-36.1%). Female sexual workers (FSWs) have the highest HSV-2 risk (ARR:1.69, 95% CI: 1.61-1.78). We found northeastern regions had a higher HSV-2 seroprevalence than other regions (17.0%, 95% CI: 4.3-35.6%, ARR: 1.38, 95% CI: 1.26-1.50, Northern China as the reference group). This highlighted the disparity by population risk levels and regions. We also found lower HSV-2 prevalence estimates in publications in Chinese bibliographic databases than those in English databases among key populations (such as MSM and HIV-discordant populations).
ConclusionThere is a gradient increase in HSV-2 prevalence risk stratification. We also identified region, population, and age disparities and heterogeneities by publication language in the HSV-2 burden. This study provides guidance for future HSV-2 prevention to eliminate disparities of HSV-2 infection and reduce overall HSV-2 burden.
Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=408108, identifier CRD42023408108.

背景：单纯疱疹病毒2型（herpes simplex type 2, HSV-2）感染的患病率持续攀升，已成为日益严峻的全球公共卫生挑战。全面掌握其在中国的流行病学特征与疾病负担差异，对未来制定精准且有效的干预策略至关重要。
方法：本研究遵循Cochrane协作网指南与PRISMA声明规范开展系统综述，纳入截至2024年3月31日发表于中英文文献数据库的相关研究。我们整合了不同人群类型的HSV-2血清患病率数据，采用随机效应模型进行Meta分析，并通过Meta回归分析探讨人群特征与血清患病率之间的关联。
结果：本研究共初检出23999篇文献，最终纳入402项符合标准的研究（涉及1203362名研究对象），这些研究报道了总体血清患病率数据（含858项分层测量结果）。普通人群（低风险组）的合并HSV-2血清患病率为7.7%（95%置信区间：6.8%~8.7%）。与普通人群相比，中风险人群（14.8%，95%CI：11.0%~19.1%）和关键人群（31.7%，95%CI：27.4%~36.1%）的HSV-2感染风险更高。其中女性性工作者（FSWs）的HSV-2感染调整率比（adjusted rate ratio, ARR）最高（1.69，95%CI：1.61~1.78）。研究发现，东北地区的HSV-2血清患病率高于其他地区（17.0%，95%CI：4.3%~35.6%，ARR：1.38，95%CI：1.26~1.50，以中国北方为参照组），这凸显了不同人群风险层级与地域间的患病率差异。此外，在关键人群（如男男性行为者（men who have sex with men, MSM）及HIV感染不一致人群）中，中文文献数据库收录的研究报道的HSV-2患病率估算值低于英文数据库文献。
结论：HSV-2的患病率随风险分层呈现梯度上升趋势。本研究同时揭示了HSV-2疾病负担在地区、人群、年龄层面的差异，以及因文献发表语言不同导致的异质性。本研究可为未来HSV-2防控工作提供科学指导，助力消除HSV-2感染的各类差异，降低整体疾病负担。
系统综述注册信息：https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=408108，标识符为CRD42023408108。