OBJECTIVES: The global burden of herpes simplex virus (HSV)-2 and -1 infection is large, but the economic consequence of HSV remains unclear. This study aims to estimate the global economic impact of HSV-2 and HSV-1 infection among adults aged 15-49 years, pregnant women and neonates, and human immunodeficiency virus (HIV) infection attributable to HSV-2.

METHODS: The global disease burden of HSV for adults, pregnant women and neonates were disaggregated by WHO region and for 194 countries. Information on healthcare resource utilisation and cost were identified through literature review and interviews. Other cost components, including direct non-medical cost (transportation) and indirect costs (lost wages) were retrieved from academic and governmental publications. Results were calculated at the country level and presented by WHO regions and World-Bank income levels. All costs were reported in 2016 international dollars (I$).

RESULTS: HSV imposed a cost of I$21.5 billion worldwide in 2016, with HSV-2 infection contributing to I$17.3 billion and HSV-1 infection I$4.2 billion. Direct cost accounted for 73% of total cost. The Americas and Western Pacific regions, represented the biggest proportion of the global burden, accounting for almost two-thirds of the costs (I$13.5 billion) due to the high disease burden and cost of healthcare. Similarly, high and upper-middle-income countries bore a large proportion of the economic burden (79.5% or I$17.1 billion). HSV resulted in indirect cost of I$5.4 billion, due to workdays lost.

CONCLUSION: This is the first study to estimate the economic burden of HSV globally. The economic burden of HSV is substantial and highlights HSV as a huge public health challenge which can be alleviated by the introduction of a HSV vaccine, it is crucial that targeted policies to accelerate the vaccine development is introduced.