الانتشار المصلى لفيروس الهربس البسيط (الدمط 1 والنمط 2) فى أوساط المجموعات السكانية ال هندية والفلبينية المهاجرة في قطر: مسح مقطعي

Background: The epidemiology of herpes simplex virus infections is of growing interest but information on its seroprevalence in many countries is scarce. Aims: This study aimed to measure the seroprevalence of herpes simplex virus type 1 and type 2 in Filipino and Indian men living in Qatar. Methods: Blood serum specimens were collected from male blood donors aged ≥ 18 years in Qatar from 2013 to 2016. HerpeSelect® 1/2 and Euroline‐WB assays were used to measure antibodies to herpes simplex virus types 1 and 2 in 120 Filipino and 325 Indian men. Results: The seroprevalence of herpes simplex virus‐1 was 84.9% (95% confidence interval (CI): 78.4–90.0%) in Filipino men and 48.3% (95% CI: 43.6–53.0%) in Indian men. The seroprevalence of herpes simplex virus‐2 was 8.3% (95% CI: 4.6–13.7%) in Filipinos and 3.7% (95% CI: 2.2–5.9%) in Indians. The seroprevalence of herpes simplex virus types 1 and 2 increased with age, but this trend was only statistically significant in Indian men (P = 0.013 and P = 0.011 respectively). Conclusions: The seroprevalence rates of herpes simplex virus‐2 in Filipino and Indian men living in Qatar were similar to those found in the Philippines and India. However, the seroprevalence of herpes simplex virus‐1 in Indians, while similar to that found in India, was substantially lower than that of other countries in Asia and developing countries worldwide, which needs further investigation.Contexte : L'épidémiologie des infections par le virus de l'herpès suscite un intérêt croissant, mais les informationsrelatives à sa séroprévalence dans de nombreux pays sont rares.Objectifs : La présente étude visait à mesurer la séroprévalence du virus de l'herpès de types 1 et 2 parmi les hommesphilippins et indiens vivant au Qatar.Méthodes : Des échantillons de sérum sanguin ont été prélevés sur des donneurs de sang masculins âgés d'au moinsdix-huit ans au Qatar entre 2013 et 2016. Les tests HerpeSelect® 1/2 et Euroline-WB ont été utilisés pour mesurer lesanticorps dirigés contre le virus de l'herpès de types 1 et 2 chez 120 hommes philippins et 325 hommes indiens.Résultats : La séroprévalence du virus de l'herpès de type 1 était de 84,9 % (intervalle de confiance (IC) à 95 % : 78,4-90,0 %)chez les hommes philippins et de 48,3 % (IC à 95 % : 43,6-53,0 %) chez les hommes indiens. La séroprévalence du virus del'herpès de type 2 était de 8,3 % (IC à 95 % : 4,6-13,7 %) chez les hommes philippins et de 3,7 % (IC à 95 % : 2,2- 5,9 %) chezles hommes indiens. La séroprévalence du virus de l'herpès de types 1 et 2 augmentait avec l'âge, mais cette tendancen'était statistiquement importante que chez les homme indiens (p = 0,013 et p = 0,011 respectivement).Conclusions : Les taux de séroprévalence du virus de l'herpès de type 2 parmi les hommes philippins et indiens vivantau Qatar étaient similaires à ceux constatés aux Philippines et en Inde. Toutefois, le taux de séroprévalence du virus del'herpès de type 1 chez les Indiens, bien que comparable à celui relevé en Inde, était beaucoup moins élevé que celui desautres pays d'Asie et des pays en développement, ce qui mérite d'être étudié plus attentivement.الخلفية: يتزايد الاهتمام بدراسة السمات الوبائية لحالات العدوى بفيروس الهريس البسيط. غير أن المعلومات حول انتشاره مصليا في العديد من البُلدان شحيحة للغاية. الأهداف: هدفت هذه الدراسة إلى قياس الانتشار المصلي لفيروس الحربس البسيط (النمط 1 والنمط 2) بين الرجال الذين يعيشون في قطر وينتمون إلى الجنسيتين الهندية والفلبينية. طرق البحث: أخذت عينات من مصل الدم من متبرعين بالدم من الذكور يبلغون من العمر 18 عاما أو أكثر في قطر في الفترة من 2013 وحتى 2016. واستّخدمت مقايستئ Euroline–WB و ® HerpeSelect 1/2 لقياس الأجسام المضادة لفيروس المريس البسيط (النمط 1 والنمط 2) لدى 120 رجلا فليبينيا و 325 رجلا هنديا. النتائج: كانت نسبة الانتشار المصلي لفيروس الهربس البسيط (النمط -1)(84.9%; 95% CI=78.4-90%) في صفوف الرجال من الجنسية الفليبينية و (48.3%; 95% CI=43.6-53.0%) في صفوف الرجال من الجنسية الهندية. كانت نسبة الانتشار المصلي لفيروس الهريس البسيط النمط 2 (8.3%; 95% CI=4.6-13.7%) في صفوف الرجال من الجنسية الفليبينية و (3.7%; 95% CI=2.2-5.9%) في صفوف الرجال من الجنسية الهندية. وارتفع معدل الانتشار المصلي لفيروس الهربس البسيط (النمط 1 والنمط 2) مع تقدم العمرء غير أن هذا الاتجاه لم يُظهر أهمية إحصائية يُعتد بها إلا بين الرجال من الجنسية الهندية (P=0.013; P=0.011) على التوالي. الاستنتاجات: كانت معدلات الانتشار المصلي لفيروس الهربس البسيط النمط 2 في صفوف الرجال من الجنسيتين الفليبينية والهندية الذين يعيشون في قطر ممائلة لنفس المعدلات الموجودة في الفلبين والهند. ولكن بالنسبة لمعدل الانتشار المصلي لفيروس الهربس البسيط النمط 1 في صفوف الرجال من الجنسية الهندية، وبالرغم من مماثلته للمعدل الموجود في الهند. فقد كان أقل بصورة ملحوظة من بُلدان أخرى في قارة آسيا وفي بلدان نامية أخرى حول العالم، وهو الأمر الذي يتطلب مزيدا من الدراس

Herpes simplex virus type 1 epidemiology in Africa: Systematic review, meta-analyses, and meta-regressions.

OBJECTIVE: To assess herpes simplex virus type 1 (HSV-1) epidemiology in Africa. METHODS: This systematic review was conducted per the Cochrane Collaboration guidelines. Findings were reported following the PRISMA guidelines. Research questions were addressed using random-effects meta-analyses and meta-regressions. RESULTS: Forty-three overall (and 69 stratified) HSV-1 seroprevalence measures, and 18 and eight proportions of HSV-1 viral detection in genital ulcer disease (GUD) and in genital herpes, respectively, were extracted from 37 reports. Pooled mean seroprevalence was 67.1% (95% confidence interval (CI): 54.7-78.5%) in children, and 96.2% (95% CI: 95.0-97.3%) in adults. Across age groups, pooled mean was 44.4% (95% CI: 29.9-59.3%) in ≤5 years-old, 85.6% (95% CI: 81.0-89.6%) in 6-15 years-old, 93.3% (95% CI: 89.2-96.6%) in 16-25 years-old, and 93.8% (95% CI: 84.6-99.4%) in >25 years-old. Age explained 78.8% of seroprevalence variation. Pooled mean proportion of HSV-1 detection was 0.4% (95% CI: 0.0-1.5%) in GUD, and 1.2% (95% CI: 0.0-4.0%) in genital herpes. CONCLUSIONS: HSV-1 is universally prevalent in Africa, at higher levels than other regions, with no evidence for declines in seroprevalence in recent decades. Nearly every person acquires the infection in childhood through oral-to-oral transmission, before sexual debut. Sexual oral-to-genital and genital-to-genital transmission appear very limited

Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa:systematic review, meta-analyses, and meta-regressions

Background: Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. Methods: Cochrane and PRISMA guidelines were followed to systematically review, synthesize, and report HSV-2 related findings up to August 23, 2020. Meta-analyses and meta-regressions were conducted. Findings: From 218 relevant publications, 451 overall outcome measures and 869 stratified measures were extracted. Pooled incidence rates ranged between 2.4–19.4 per 100 person-years across populations. Pooled seroprevalence was lowest at 37.3% (95% confidence interval (CI): 34.9–39.7%) in general populations and high in female sex workers and HIV-positive individuals at 62.5% (95% CI: 54.8–70.0%) and 71.3% (95% CI: 66.5–75.9%), respectively. In general populations, pooled seroprevalence increased steadily with age. Compared to women, men had a lower seroprevalence with an adjusted risk ratio (ARR) of 0.61 (95% CI: 0.56–0.67). Seroprevalence has decreased in recent decades with an ARR of 0.98 (95% CI: 0.97–0.99) per year. Seroprevalence was highest in Eastern and Southern Africa. Pooled HSV-2 proportion in genital ulcer disease was 50.7% (95% CI: 44.7–56.8%) and in genital herpes it was 97.3% (95% CI: 84.4–100%). Interpretation: Seroprevalence is declining by 2% per year, but a third of the population is infected. Age and geography play profound roles in HSV-2 epidemiology. Temporal declines and geographic distribution of HSV-2 seroprevalence mirror that of HIV prevalence, suggesting sexual risk behavior has been declining for three decades. HSV-2 is the etiological cause of half of genital ulcer disease and nearly all genital herpes cases with limited role for HSV-1. Funding: This work was supported by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar and by the Qatar National Research Fund [NPRP 9–040–3–008]

Herpes simplex virus type 1 epidemiology in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions.

This study aimed at characterizing herpes simplex virus type 1 (HSV-1) epidemiology in the Middle East and North Africa (MENA). HSV-1 records were systematically reviewed. Findings were reported following the PRISMA guidelines. Random-effects meta-analyses were implemented to estimate pooled mean HSV-1 seroprevalence. Random-effects meta-regressions were conducted to identify predictors of higher seroprevalence. Thirty-nine overall seroprevalence measures yielding 85 stratified measures were identified and included in the analyses. Pooled mean seroprevalence was 65.2% (95% CI: 53.6-76.1%) in children, and 91.5% (95% CI: 89.4-93.5%) in adults. By age group, seroprevalence was lowest at 60.5% (95% CI: 48.1-72.3%) in <10 years old, followed by 85.6% (95% CI: 80.5-90.1%) in 10-19 years old, 90.7% (95% CI: 84.7-95.5%) in 20-29 years old, and 94.3% (95% CI: 89.5-97.9%) in ≥30 years old. Age was the strongest predictor of seroprevalence explaining 44.3% of the variation. Assay type, sex, population type, year of data collection, year of publication, sample size, and sampling method were not significantly associated with seroprevalence. The a priori considered factors explained 48.6% of the variation in seroprevalence. HSV-1 seroprevalence persists at high levels in MENA with most infections acquired in childhood. There is no evidence for declines in seroprevalence despite improving socio-economic conditions

HIV epidemiology among female sex workers and their clients in the Middle East and North Africa:systematic review, meta-analyses, and meta-regressions

BACKGROUND: HIV epidemiology among female sex workers (FSWs) and their clients in the Middle East and North Africa (MENA) region is poorly understood. We addressed this gap through a comprehensive epidemiological assessment. METHODS: A systematic review of population size estimation and HIV prevalence studies was conducted and reported following PRISMA guidelines. Risk of bias (ROB) assessments were conducted for all included studies using various quality domains, as informed by Cochrane Collaboration guidelines. The pooled mean HIV prevalence was estimated using random-effects meta-analyses. Sources of heterogeneity and temporal trends were identified through meta-regressions. RESULTS: We identified 270 size estimation studies in FSWs and 42 in clients, and 485 HIV prevalence studies in 287,719 FSWs and 69 in 29,531 clients/proxy populations. Most studies had low ROB in multiple quality domains. The median proportion of reproductive-age women reporting current/recent sex work was 0.6% (range = 0.2-2.4%) and of men reporting currently/recently buying sex was 5.7% (range = 0.3-13.8%). HIV prevalence ranged from 0 to 70% in FSWs (median = 0.1%) and 0-34.6% in clients (median = 0.4%). The regional pooled mean HIV prevalence was 1.4% (95% CI = 1.1-1.8%) in FSWs and 0.4% (95% CI = 0.1-0.7%) in clients. Country-specific pooled prevalence was < 1% in most countries, 1-5% in North Africa and Somalia, 17.3% in South Sudan, and 17.9% in Djibouti. Meta-regressions identified strong subregional variations in prevalence. Compared to Eastern MENA, the adjusted odds ratios (AORs) ranged from 0.2 (95% CI = 0.1-0.4) in the Fertile Crescent to 45.4 (95% CI = 24.7-83.7) in the Horn of Africa. There was strong evidence for increasing prevalence post-2003; the odds increased by 15% per year (AOR = 1.15, 95% CI = 1.09-1.21). There was also a large variability in sexual and injecting risk behaviors among FSWs within and across countries. Levels of HIV testing among FSWs were generally low. The median fraction of FSWs that tested for HIV in the past 12 months was 12.1% (range = 0.9-38.0%). CONCLUSIONS: HIV epidemics among FSWs are emerging in MENA, and some have reached stable endemic levels, although still some countries have limited epidemic dynamics. The epidemic has been growing for over a decade, with strong regionalization and heterogeneity. HIV testing levels were far below the service coverage target of "UNAIDS 2016-2021 Strategy.

The Epidemiology of Herpes Simplex Virus Type 1 in Asia: Systematic Review, Meta-analyses, and Meta-regressions.

BACKGROUND: Herpes simplex virus type 1 (HSV-1) epidemiology in Asia was characterized by assessing seroprevalence levels and extent to which HSV-1 is isolated from clinically diagnosed genital ulcer disease (GUD) and genital herpes. METHODS: HSV-1 reports in Asia were systematically reviewed and synthesized, following PRISMA guidelines. Random-effects meta-analyses estimated pooled mean seroprevalence and proportion of HSV-1 detection in GUD and genital herpes. Random-effects meta-regressions identified predictors of seroprevalence and sources of between-study heterogeneity. RESULTS: Forty-nine relevant publications were identified. Fifty-four overall seroprevalence measures (182 stratified measures), and 8 and 24 proportions of HSV-1 detection in GUD and in genital herpes, respectively, were extracted. The pooled mean seroprevalence was 50.0% (n = 26; 95% confidence interval [CI], 41.3%-58.7%) for children and 76.5% (n = 151; 73.3%-79.6%) for adults. By age group, the pooled mean was lowest at 55.5% (n = 37; 95% CI, 47.5%-63.4%) in individuals aged <20 years, followed by 67.9% (n = 48; 62.4%-73.3%) in those aged 20-39 and 87.5% (n = 44; 83.4%-91.1%) in those aged ≥40 years. In meta-regression, age was the major predictor of seroprevalence. The mean proportion of HSV-1 detection was 5.6% (n = 8; 95% CI, 0.8%-13.6%) in GUD and 18.8% (n = 24; 12.0%-26.7%) in genital herpes. CONCLUSIONS: HSV-1 epidemiology is transitioning in Asia. HSV-1 is probably playing a significant role as a sexually transmitted infection, explaining one-fifth of genital herpes cases. There is a need for expanded seroprevalence monitoring and GUD/genital herpes etiological surveillance

Epidemiology of herpes simplex virus type 2 in the Middle East and North Africa: Systematic review, meta-analyses, and meta-regressions

Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with poorly characterized prevalence in the Middle East and North Africa (MENA) region. This study characterized HSV-2 epidemiology in MENA. HSV-2 reports were systematically reviewed as guided by the Cochrane Collaboration Handbook and findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to estimate pooled mean outcome measures and to assess predictors of HSV-2 antibody prevalence (seroprevalence), trends in seroprevalence, and between-study heterogeneity. In total, sixty-one overall (133 stratified) HSV-2 seroprevalence measures and two overall (four stratified) proportion measures of HSV-2 detection in laboratory-confirmed genital herpes were extracted from 37 relevant publications. Pooled mean seroprevalence was 5.1% (95% confidence interval [CI]: 3.6%–6.8%) among general populations, 13.3% (95% CI: 8.6%–18.7%) among intermediate-risk populations, 20.6% (95% CI: 5.3%–42.3%) among female sex workers, and 18.3% (95% CI: 3.9%–39.4%) among male sex workers. Compared to Fertile Crescent countries, seroprevalence was 3.39-fold (95% CI: 1.86–6.20) and 3.90-fold (95% CI: 1.78–8.57) higher in Maghreb and Horn of Africa countries, respectively. Compared to studies published before 2010, seroprevalence was 1.73-fold (95% CI: 1.00–2.99) higher in studies published after 2015. Pooled mean proportion of HSV-2 detection in genital herpes was 73.8% (95% CI: 42.2%–95.9%). In conclusion, MENA has a lower HSV-2 seroprevalence than other world regions. Yet, 1 in 20 adults is chronically infected, despite conservative prevailing sexual norms. Seroprevalence may also be increasing, unlike other world regions. Findings support the need for expansion of surveillance and monitoring of HSV-2 infection in MENA.This work was supported by the Qatar National Research Fund [NPRP 9-040-3-008] and by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar

Hepatitis C virus viremic rate in the Middle East and North Africa: Systematic synthesis, meta-analyses, and meta-regressions.

OBJECTIVES: To estimate hepatitis C virus (HCV) viremic rate, defined as the proportion of HCV chronically infected individuals out of all ever infected individuals, in the Middle East and North Africa (MENA). METHODS: Sources of data were systematically-gathered and standardized databases of the MENA HCV Epidemiology Synthesis Project. Meta-analyses were conducted using DerSimonian-Laird random-effects models to determine pooled HCV viremic rate by risk population or subpopulation, country/subregion, sex, and study sampling method. Random-effects meta-regressions were conducted to identify predictors of higher viremic rate. RESULTS: Analyses were conducted on 178 measures for HCV viremic rate among 19,593 HCV antibody positive individuals. In the MENA region, the overall pooled mean viremic rate was 67.6% (95% CI: 64.9-70.3%). Across risk populations, the pooled mean rate ranged between 57.4% (95% CI: 49.4-65.2%) in people who inject drugs, and 75.5% (95% CI: 61.0-87.6%) in populations with liver-related conditions. Across countries/subregions, the pooled mean rate ranged between 62.1% (95% CI: 50.0-72.7%) and 70.4% (95% CI: 65.5-75.1%). Similar pooled estimates were further observed by risk subpopulation, sex, and sampling method. None of the hypothesized population-level predictors of higher viremic rate were statistically significant. CONCLUSIONS: Two-thirds of HCV antibody positive individuals in MENA are chronically infected. Though there is extensive variation in study-specific measures of HCV viremic rate, pooled mean estimates are similar regardless of risk population or subpopulation, country/subregion, HCV antibody prevalence in the background population, or sex. HCV viremic rate is a useful indicator to track the progress in (and coverage of) HCV treatment programs towards the set target of HCV elimination by 2030