Product information and disease description Place of product in therapy Disease description Epidemiology

Prevalence of Refractory mucocutaneous herpes simplex virus infection in immunocompromised adults

43 evidence topics · 33 sources

Resistance rates by population in the consensus review

Population	Reported rate
Immunocompetent patients	“very low (<1%)”
Hematopoietic cell transplant recipients	“often ranging from 0% to 14% in hematopoietic cell transplant (HCT) recipients”
Solid organ transplant recipients	“0%–3% of solid-organ transplant (SOT) recipients”
Advanced HIV disease	“with prevalence rates of 3%–7%”
People with HIV receiving effective antiretroviral treatment	“they are much less common in patients receiving effective antiretroviral treatment”

Prevalence by population in a review of resistance to nucleoside analogues

Population	Reported prevalence
Immunocompetent patients, United Kingdom and United States surveys	“A low prevalence of HSV resistance to ACV was reported in immunocompetent patients during extensive screening surveys in the United Kingdom (0.7%) and the United States (0.3%) between 1980 and 1992”
Immunocompromised patients overall	“The prevalence of HSV infections with reduced susceptibility to ACV in immunocompromised patients is higher and varies from 3.5% to 10%”
HIV-positive patients	“The prevalence of ACV resistance has ranged from 3.5% to 7% in HIV-positive patients”
Solid organ transplant recipients	“from 2.5% to 10% in solid organ transplant recipients”
Hematopoietic stem cell recipients	“However, the highest prevalence rates have been reported in recipients of hematopoietic stem cells, with a range of 4.1% to 10.9%”
Hematopoietic stem cell recipients, highest single report	“An even higher frequency (36%) of ACV resistance in that population has also been reported”

Systematic review of prevalence: immunocompetent and immunocompromised populations

“Defining the global prevalence of acyclovir resistance in HSV infections is hampered by the high variability in methodology, patient selection, study design, and treatment history among the studies.” (opens the source at this quote in a new tab)
“Acyclovir resistant HSV is infrequent in the immunocompetent population (generally below 1%), irrespective of treatment history.” (opens the source at this quote in a new tab)
“Higher frequencies of acyclovir resistant HSV infections are reported among immunocompromised individuals, with the highest prevalence seen among hematopoietic stem cell transplant recipients.” (opens the source at this quote in a new tab)

Hematopoietic cell transplant recipients: range of prevalence of refractory and resistant infection in a narrative review

“The prevalence of refractory and resistant (R/R) HSV infections in HCT recipients mostly ranges from 0% to 14%, with few studies of small sample sizes reporting a prevalence of up to 46%” (opens the source at this quote in a new tab)

Stability of prevalence over two decades: resistance among isolates by immune status

“the prevalence of acyclovir resistance in herpes simplex virus isolates from immunocompetent hosts has remained stable at approximately 0.3%. In immuncompromised patients, in whom the risk for developing resistance is much greater, the prevalence of resistant virus has also remained stable but at a higher level, typically 4 to 7%.” (opens the source at this quote in a new tab)
“Surveys in North America and Europe of HSV isolates from immunocompromised patients treated with acyclovir indicate that the prevalence of resistant HSV is generally between 4 and 7%” (opens the source at this quote in a new tab)
“Thus, despite widespread and increasing use of antivirals to treat HSV infections (Fig. 3), the frequency of resistant HSV even in high-risk, immunocompromised patients has remained stable for almost 20 years.” (opens the source at this quote in a new tab)

“Antiviral treatment of herpes simplex virus (HSV) infections with nucleoside analogues has been well established for >2 decades, but isolation of drug-resistant HSV from immunocompetent patients has remained infrequent (0.1%-0.7% of isolates) during this period.” (opens the source at this quote in a new tab)
“Although drug-resistant HSV is more commonly isolated from immunocompromised patients (4%-7% of isolates) and is more likely to be clinically significant, the prevalence of drug-resistant HSV even among these patients, has been stable over the past 2 decades.” (opens the source at this quote in a new tab)

Reported cases of clinical resistance by underlying condition

“Of 184 cases of clinical resistance reported between 1982 and 1994, 160 occurred in patients with AIDS and 24 occurred in patients who were otherwise immunocompromised, usually because of bone marrow transplantation” (opens the source at this quote in a new tab)

French surveillance network of 15 laboratories: patients excreting acyclovir-resistant strains by immune status

“Between May 1999 and April 2002, 4,098 isolates, corresponding to 3521 patients, were collected.” (opens the source at this quote in a new tab)
“The population studied was 55% immunocompetent patients (n = 1,855) and 45% immunocompromised patients (n = 1,502) (Table 1).” (opens the source at this quote in a new tab)
“In conclusion, 0.3% of immunocompetent patients excreted ACV-resistant strains, in contrast to 3.6% of immunocompromised patients (P < 0.001). The percentage of ACV-resistant HSV-2 strains is not significantly higher than the percentage of HSV-1 strains.” (opens the source at this quote in a new tab)
“Only six immunocompetent patients excreted ACV-resistant HSV strains (0.32%), including one female patient not treated with ACV who was infected primary by an ACV-resistant strain. Among the 54 immunocompromised patients from whom ACV-resistant HSV strains were isolated (3.5%), the bone marrow transplantation patients showed the highest prevalence of resistance (10.9%), whereas among patients infected by human immunodeficiency virus, the prevalence was 4.2%.” (opens the source at this quote in a new tab)
“The main causes of immunosuppression were hemopathy (32% of the cases), HIV infections (21% of the cases), organ transplantations (13.5% of the cases), and bone marrow transplantations (13.5% of the cases) (Table 5).” (opens the source at this quote in a new tab)

French surveillance network: bone marrow transplant recipients excreting acyclovir-resistant strains

“Of the 201 patients who received bone marrow transplants, 22 excreted ACV-resistant HSV-1 strains (10.9%). This value was 18.4% for allotransplantations (16 of 87) and 1.2% for autotransplantations (1 of 81) (P < 0.001).” (opens the source at this quote in a new tab)
“The prevalence of resistance is highest (10.9%) in patients who have had a bone marrow transplant, particularly for those who have had allotransplants (18.4%), with a significant difference in relation to the other categories of immunocompromised patients (P < 0.001).” (opens the source at this quote in a new tab)

French surveillance network: patients with hematologic disease excreting acyclovir-resistant strains

“Of the 512 patients with hemopathy, 11 excreted ACV-resistant strains (2.1%). Among the nine patients excreting HSV-1 strains, four had lymphoma, three had leukemia (two acute leukemia and one lymphatic leukemia), and two had bone marrow aplasia. Among the two patients excreting HSV-2 strains, one had lymphoma and the other had myelodysplasia.” (opens the source at this quote in a new tab)

French surveillance network: patients with HIV infection excreting acyclovir-resistant strains

“Of the 310 patients with HIV infection, 13 excreted ACV-resistant HSV-2 strains (4.2%). Among these, eight had a CD4 level of less than 200/mm3 (between 18 and 200/mm3), and four had a higher level (up to 800/mm3). These recurrent infections were localized to the anogenital region (Table 6).” (opens the source at this quote in a new tab)

French surveillance network: solid organ transplant recipients excreting acyclovir-resistant strains

“Of the 201 patients who received an organ transplant, 5 excreted ACV-resistant strains (2.5%).” (opens the source at this quote in a new tab)

French surveillance network: other immunocompromised groups

“Three of the 119 patients belonging to the miscellaneous category excreted ACV-resistant strains. Two patients with common variable immune deficiency excreted ACV-resistant HSV-2 strains during recurrent genital infections (Table 6); they had previously been treated with ACV.” (opens the source at this quote in a new tab)
“The third patient had pemphigus, for which he was treated with corticotherapy, and he excreted the herpesvirus during a recurrent infection of the upper region.” (opens the source at this quote in a new tab)
“The other immunocompromised patients included in the study did not excrete ACV-resistant strains; 84 of these patients had solid cancer, 58 were treated with corticotherapy for causes such as asthma or lupus or while waiting for a transplantation, and 24 who had serious burns excreted HSV-1 strains.” (opens the source at this quote in a new tab)

French surveillance network: foscarnet resistance and clinical resistance among patients with acyclovir-resistant strains

“In 38% of the cases, the patients who excreted the ACV-resistant strains were treated with foscarnet (PFA), and 61% of them developed resistance to PFA.” (opens the source at this quote in a new tab)
“Of the 12 ACV-resistant patients treated with PFA, 7 excreted PFA-resistant strains (Table 6).” (opens the source at this quote in a new tab)
“Of the 54 immunocompromised patients, 36 had clinical resistance, 24 of whom excreted chronic strains and 5 of whom had multiple recurrences.” (opens the source at this quote in a new tab)
“Chronic excretion of ACV-resistant strains is frequent in patients with HIV infection (61%) and in patients who have received a bone marrow transplant (41%).” (opens the source at this quote in a new tab)

Survey in northwest England: resistance among isolates by immune status

“More than 2,000 HSV isolates from both immunocompetent and immunocompromised patients in northwest England were collected over a 2-year period and tested for sensitivity to ACV. These studies suggested a prevalence of resistance of approximately 0.1 to 0.6% in immunocompetent individuals, with no apparent difference in prevalence between treated and untreated groups. In line with previous studies, the prevalence of resistance in treated immunocompromised individuals was approximately 6%.” (opens the source at this quote in a new tab)
“A number of isolates (n = 146) were from 95 severely immunocompromised patients who were being treated at local hospitals and who were also on ACV treatment, and again, for this group good clinical data were available.” (opens the source at this quote in a new tab)

Survey in northwest England: patients treated for cancer shedding resistant virus

“Of the 46 patients who were undergoing treatment for cancer, 3 (6.5%) shed resistant virus.” (opens the source at this quote in a new tab)

Survey in northwest England: heart or lung transplant recipients shedding resistant virus

“A further 20 patients were on immunosuppressive therapy following heart or lung transplantation. Two of these (10%) shed resistant virus.” (opens the source at this quote in a new tab)

Survey in northwest England: HIV-infected patients shedding resistant virus

“Finally, there were 29 human immunodeficiency virus (HIV)-infected individuals, and of these only 1 (3.4%) shed a resistant variant. Of the HIV-infected individuals, 17 were diagnosed with AIDS, and it was one of these individuals who shed resistant virus. Thus, the approximate incidence of ACV-resistant virus in AIDS patients was 6%.” (opens the source at this quote in a new tab)

Survey in the Netherlands: patients with resistant isolates by immune status and transplant status

“A total of 542 isolates, 410 HSV-1 and 132 HSV-2, from 496 patients were screened for reduced susceptibility to ACV.” (opens the source at this quote in a new tab)
“Thirteen isolates, 8 HSV-1 and 5 HSV-2, from 10 patients (2%) were found resistant to ACV. A single ACV-resistant strain was identified among isolates from 368 immunocompetent patients (0.27%; 95% confidence interval [CI], 0.007%-1.5%), whereas in nine isolates from 128 immunocompromised patients resistant HSV was identified (7%; 95% CI, 3.26%-12.93%). The highest frequency of ACV-resistant HSV was associated with bone marrow transplantation: four patients out of 28 (14.3%) shed resistant virus. In addition, resistant virus was obtained from two HIV-positive patients, one patient with a hematological malignancy and two patients on immunosuppressive drugs. Further testing showed that none of the isolates was resistant to foscarnet.” (opens the source at this quote in a new tab)

Ten-year French survey: change in prevalence among immunocompromised patients and allogeneic transplant recipients

“ACV resistance has traditionally been a major concern for immunocompromised patients with a frequency reported between 2.5% and 10%.” (opens the source at this quote in a new tab)
“This was done by retrospectively following 1425 patients. In immunocompetent patients, prevalence of resistance did not exceed 0.5% during the study period; whereas in immunocompromised patients, a significant increase was observed, rising from 3.8% between 2002 and 2006 (7/182 patients) to 15.7% between 2007 and 2011 (28/178) (p=0.0001). This sharp rise in resistance may largely be represented by allogeneic hematopoietic stem cell transplant patients, in which the prevalence of ACV resistance rose similarly from 14.3% (4/28) between 2002 and 2006 to 46.5% (26/56) between 2007 and 2011 (p=0.005). No increase in ACV resistance was detected in association with other types of immune deficiencies.” (opens the source at this quote in a new tab)

Four-year French laboratory survey: resistance among samples referred for suspected resistance

“A total of 211 HSV-positive clinical samples (94 HSV-1 and 117 HSV-2) recovered from 139 patients (11 immunocompetent patients, 85 immunocompromised patients, and 43 patients with unknown immune status) with suspected HSV drug-resistance were analyzed for acyclovir and foscarnet susceptibility.” (opens the source at this quote in a new tab)
“As a whole, susceptibility and resistance to antivirals were evidenced for 58 (30.7%) and 86 (45.5%) HSV, respectively, whereas antiviral profile remained undetermined for 45 (23.8%) HSV. The prevalence of drug resistance was significantly higher among HSV-2 isolates than among HSV-1 isolates (53.8% vs. 34.9%; p=0.012).” (opens the source at this quote in a new tab)

United States tertiary care center: patients with resistant isolates by immune status

“Consecutive herpes simplex virus isolates were collected from 207 patients, including immunocompetent patients, patients with malignancy, neonates, bone marrow and organ transplant recipients, and patients seropositive for human immunodeficiency virus.” (opens the source at this quote in a new tab)
“Acyclovir-resistant herpes simplex viruses were recovered from 7 of 148 immunocompromised patients (4.7%) but from none of 59 immunocompetent hosts. Clinical disease was found in all 7 patients with resistant herpes simplex virus and was more severe in pediatric patients.” (opens the source at this quote in a new tab)

United States sexually transmitted disease and HIV clinics: acyclovir-resistant genital isolates by HIV status

“We identified and attempted to enroll all patients 18 years or older with suspected genital herpes who attended 22 sexually transmitted disease and human immunodeficiency virus (HIV) clinics in the United States between October 1996 and April 1998.” (opens the source at this quote in a new tab)
“Three (0.18%) of 1644 HIV-negative patients had acyclovir-resistant isolates (95% confidence interval [CI], 0.04%-0.5%); resistance was associated with oral (P<.006) and topical (P<.001) acyclovir use.” (opens the source at this quote in a new tab)
“In the 15 years following licensure of acyclovir, resistance to the drug remains low among immunocompetent patients. However, 5% of HIV-positive patients had resistant HSV-2 isolates.” (opens the source at this quote in a new tab)

People with HIV in a French hospital cohort: patients with confirmed acyclovir-resistant infection over 10 years

“We retrospectively studied all HIV-infected patients between 2000 and 2010 diagnosed with virologically confirmed acyclovir-resistant HSV infection.” (opens the source at this quote in a new tab)
“Among 5295 HIV-infected patients, 13 (0.2%) were once diagnosed with an acyclovir-resistant HSV infection.” (opens the source at this quote in a new tab)
“Acyclovir-resistant HSV infection prevalence was low in our cohort.” (opens the source at this quote in a new tab)

People with HIV: resistance among genital isolates as stated in guidelines

“Herpes resistant to aciclovir is very rarely described in the immunocompetent and is usually associated with immunosuppression and not necessarily HIV related” (opens the source at this quote in a new tab)
“In prospective studies, aciclovir-resistant strains have been found in around 5%–7% isolates from genital herpes lesions in people living with HIV.” (opens the source at this quote in a new tab)

Allogeneic transplant recipients with HSV-1 infection in a United Kingdom center: share with acyclovir resistance

“Between June 2011 and June 2019, medical records of 532 HSCT recipients with suspected HSV infection were retrospectively analyzed. HSV-1 and HSV-2 positive samples were identified in 47 and 16 patients respectively.” (opens the source at this quote in a new tab)
“The prevalence of ACV-resistant HSV accounted for 17% (8/48) of infected HSV-1 cases.” (opens the source at this quote in a new tab)

Hematopoietic cell transplant recipients with refractory infection at 7 United States centers: laboratory-confirmed resistance among those tested

“Of 104 patients tested for acyclovir resistance, 85 (81.7%) had laboratory-confirmed acyclovir resistance, by phenotypic assay (79 patients) or genotypic assays (6 patients)” (opens the source at this quote in a new tab)
“Four patients had laboratory-confirmed foscarnet resistance, by phenotypic assays.” (opens the source at this quote in a new tab)
“Acyclovir resistance occurs in up to 14% of HCT recipients, with estimates varying widely across studies” (opens the source at this quote in a new tab)

Immunocompromised adults treated with foscarnet at 5 United States sites: resistant and refractory episodes

“Twenty-nine patients had 31 episodes of HSV (15/18 resistant; among episodes without resistance testing, 7/10 refractory; 3 not evaluable) treated with foscarnet. All patients were immunocompromised including 19 (66%) with hematologic malignancy and 9 (31%) with HIV.” (opens the source at this quote in a new tab)

Pivotal trial population: share with laboratory-confirmed acyclovir resistance at enrollment

“At enrollment, the majority of participants, 71%, had refractory HSV infection and 29% had laboratory confirmed ACV resistance.” (opens the prescribing information at this quote)

Allogeneic transplant recipients with resistant infection at one United States center: dual resistance to foscarnet and acyclovir

“dual resistance to foscarnet and acyclovir was seen in six of our patients” (opens the source at this quote in a new tab)
“all of those patients had been exposed to foscarnet within the month prior to HSV infection.” (opens the source at this quote in a new tab)

Solid organ transplant recipients: susceptibility of isolates after prophylaxis

“We determined the acyclovir (ACV) susceptibilities of herpes simplex virus (HSV) isolates (n = 18) recovered from solid organ transplant patients after antiviral prophylaxis with ACV or ganciclovir. All isolates tested were susceptible to ACV (50% inhibitory concentration, < 1 microM).” (opens the source at this quote in a new tab)

Solid organ transplant recipients: guideline statement on relative frequency

“Acyclovir-resistant HSV is less common in SOT patients than in HSCT and can be treated with foscarnet, though other novel therapies are currently under investigation.” (opens the source at this quote in a new tab)

Patients with a positive HSV polymerase chain reaction at a French center: confirmed genotypic resistance over 8 years

“Among the 1,558 patients with a positive HSV PCR, we identified 11 cases of confirmed genotypic ACV resistance over an 8-year period (0.7%)” (opens the source at this quote in a new tab)
“Ten adult patients with confirmed resistance to at least one antiviral agent were included.” (opens the source at this quote in a new tab)
“In our series, 9 out of the 10 cases occurred in patients with impaired immune function, while the only immunocompetent individual likely had a localized immune dysfunction.” (opens the source at this quote in a new tab)

German laboratory collection of HSV-1 strains over four decades: acyclovir-resistant strains and trend

“A total of 302 clinical herpes simplex virus 1 (HSV-1) strains, collected over 4 decades from 1973 to 2014, were characterized retrospectively for drug resistance.” (opens the source at this quote in a new tab)
“Resistance to ACV was confirmed phenotypically for 16 isolates, and resistance to ACV plus FOS was confirmed for 1 isolate. Acyclovir-resistant strains were observed from the year 1995 onwards, predominantly in immunosuppressed patients, especially those with stem cell transplantation, and the number of ACV-resistant strains increased during the last 2 decades.” (opens the source at this quote in a new tab)

United States patient-count estimate stated by the company

“Pritelivir is anticipated to address approximately 15,000 immunocompromised patients in the U.S. and is projected to achieve meaningful penetration in the second-line setting, potentially approaching 70%, subject to market conditions.” (opens the source at this quote in a new tab)

United States patient-count estimates by line of treatment in the company briefing

Measure	Value on the slide
Slide title	“Pritelivir: Potential Market in the U.S. and Clinical Positioning”
Quantity estimated	“Estimated number of patients in the U.S.”
First-line treatment	“≈180,000”
Share that proceeds to second-line treatment	“5-20%”; “(Depending on the underlying disease)”
Second-line treatment	“≈15,000”
Criterion for second-line treatment	“When symptoms fail to improve and acyclovir resistance is suspected, 2nd line treatment is initiated”
Basis of the estimates	“Based on internal investigation”

United States claims and health record analysis: data source and cohort definitions

“Retrospective cohort study using linked U.S. EHR and administrative claims data (HealthVerity, Inovalon closed claims, Arcadia EHR) from Jan 1, 2022–Dec 31, 2024. This study included patients with ≥1 ICD-10 HSV diagnosis and activity in both data sources.” (opens the source at this quote in a new tab)
“Treatment-modification patterns included: switching within first line (1L) therapy, dose escalation, route of administration transitions, and escalation to second line (2L) therapies. These patterns were proxies, not confirmation of R±R HSV.” (opens the source at this quote in a new tab)
“IC patients were identified via evidence of ICD-10 codes for HCT, SOT, PLWH, or IC Rx within a 12-month look-back; IC-specific analyses required ≥1 medical and ≥1 pharmacy claim within 12 months post-diagnosis.” (opens the source at this quote in a new tab)
“U.S. prevalence estimates were projected by applying age- and sex-specific HSV prevalence rates from claims to Census data.” (opens the source at this quote in a new tab)
“Funding: AiCuris Anti-infective Cures AG” (opens the source at this quote in a new tab)

United States claims and health record analysis: diagnosed HSV cases and immunocompromised subgroups

“A total of 1,928,480 patients with HSV infection were identified, of whom 189,412 had overlapping claims and EHR activity during 2022–2024. Applying age- and sex-specific prevalence rates from the claims dataset to U.S. Census data projected approximately 3.9 million diagnosed HSV cases nationally in 2024.” (opens the source at this quote in a new tab)
“Of the 189,412 patients, 152,835 had ≥1 medical and ≥1 pharmacy claim within 12 months of HSV diagnosis and were included in the analyses.” (opens the source at this quote in a new tab)
“Among the study cohort (n=152,835), 6.8% (n=10,412) were IC. Subgroup prevalence within the IC cohort was: 0.19% (n=285) for HCT, 0.35% (n=537) for SOT, 2.12% (n=3,244) for PLWH, and 4.15% (n=6,346) for IC Rx.” (opens the source at this quote in a new tab)

United States claims and health record analysis: treatment-modification patterns used as proxies for refractory infection

“Patterns of treatment used as proxies for refractory HSV infection were observed in this cohort. Upward dose titration occurred in 7.6% (n=9,138), switching between first-line agents in 11.8% (n=14,196), and route changes in 5.3% (n=6,367); escalation from first-line to second-line therapy agents occurred in 1% (n=1,247) (Figure 2).” (opens the source at this quote in a new tab)
“Overall, 2,110 (20.3%) IC patients exhibited at least one treatment-change pattern (HCT: n=138; SOT: n=130; PLWH: n=612; IC Rx: n=1,230). Among HCT patients, 72.5% switched between first-line agents and 42% required dose titration. Similar trends were observed across other IC groups: 54.6% and 43.8% in SOT patients, 51.3% and 36.8% in PLWH, and 58.9% and 43.5% in patients receiving IC Rx, respectively (Figure 3).” (opens the source at this quote in a new tab)
“Counts represent IC patients with ≥1 modification pattern and are not prevalence figures; counts are not mutually exclusive.” (opens the source at this quote in a new tab)

United States claims and health record analysis: modification patterns among immunocompromised patients with any pattern, by subgroup

Pattern	Hematopoietic cell transplant	Solid organ transplant	People living with HIV	Immunocompromising therapy
Upward titration	“42.0% (n=58)”	“43.8% (n=57)”	“36.8% (n=225)”	“43.5% (n=535)”
Switch within first-line therapy	“72.5% (n=100)”	“54.6% (n=71)”	“51.3% (n=314)”	“58.9% (n=725)”
Route of administration change	“18.1% (n=25)”	“26.2% (n=34)”	“29.9% (n=183)”	“30.3% (n=373)”
Switch from first-line to second-line therapy	“13.8% (n=19)”	“11.5% (n=15)”	“17.2% (n=105)”	“8.2% (n=101)”
Second-line therapy without a first-line switch	“1.4% (n=2)”	“6.2% (n=8)”	“5.6% (n=34)”	“2.8% (n=34)”

Size of the United States immunocompromised adult population: National Health Interview Survey 2021

“Of the 29 164 (unweighted) eligible adults, 6.6% (95% CI, 6.2%-6.9%) (weighted) had current immunosuppression based on their reported health conditions, prescriptions, and medical treatments. The weighted prevalence was 4.4% for having an immunosuppressive condition, 3.9% for taking an immunosuppressive medication, and 1.8% for both; the weighted prevalence of having hematological cancer was 0.1%. These categories were not mutually exclusive.” (opens the source at this quote in a new tab)
“Study limitations include reliance on self-reported immunosuppression and the lack of data on the specific causes of immunosuppression.” (opens the source at this quote in a new tab)

Size of the United States immunocompromised adult population: National Health Interview Survey 2013

“Of 34 426 eligible adult respondents within these households, 4.2% (n = 1442) had been told at some time by a health professional that their immune system was weakened. Of these, 2.8% (n = 951) reported current immunosuppression and additional evidence of immunosuppression, translating to an estimated US prevalence of 2.7% (95% CI, 2.4%-2.9%). In sensitivity analyses, prevalence ranged from 1.8% (95% CI, 1.6%-2.0%) to 3.1% (95% CI, 2.9%-3.3%).” (opens the source at this quote in a new tab)

Seroprevalence of HSV-1 and HSV-2 in the United States

“During 2015–2016, prevalence of herpes simplex virus type 1 (HSV-1) was 47.8%, and prevalence of herpes simplex virus type 2 (HSV-2) was 11.9%.” (opens the source at this quote in a new tab)
“The prevalence of HSV-1 among persons aged 14–49 was 47.8% (48.1% when adjusted for age) (Figure 1).” (opens the source at this quote in a new tab)
“The prevalence of HSV-2 among persons aged 14–49 was 11.9% (12.1% when adjusted for age) (Figure 3).” (opens the source at this quote in a new tab)

Seroprevalence of HSV among people with HIV

“approximately 60% of people with HIV were HSV-2 seropositive, and 96% were seropositive for either HSV-1 or HSV-2.” (opens the source at this quote in a new tab)