ABSTRACT

Purpose: We aimed to review available data on the incidence of herpes simplex virus (HSV) keratitis and other HSV ocular disease and to estimate the global burden of HSV ocular disease. Methods: We searched Medline and Embase databases to October 2020 for studies reporting on the incidence of HSV ocular disease. Study quality was evaluated using a four-point checklist. Pooled estimates were applied to 2016 population data to estimate global HSV ocular disease burden. Numbers with uniocular vision impairment (any visual acuity <6/12) were estimated by applying published risks to case numbers. Results: Fourteen studies had incidence data; seven met our quality criteria. In 2016, an estimated 1.7 (95% confidence interval, 95% CI 1.0–3.0) million people had HSV keratitis, based on a pooled incidence of 24.0 (95% CI 14.0–41.0; N = 2; I² = 97.7%) per 100,000 person-years. The majority had epithelial keratitis (pooled incidence 16.1 per 100,000; 95% CI 11.6–22.3; N = 3; I² = 92.6%). Available studies were few and limited to the USA and Europe. Data were even more limited for HSV uveitis and retinitis, although these conditions may collectively contribute a further >0.1 million cases. Based on global incidence, some 230,000 people may have newly acquired uniocular vision impairment associated with HSV keratitis in 2016. Conclusion: Over 1.8 million people may have herpetic eye disease annually. Preventing HSV infection could therefore have an important impact on eye health. Herpetic eye disease burden is likely to have been underestimated, as many settings outside of the USA and Europe have higher HSV-1 prevalence and poorer access to treatment.

摘要

目的：我们旨在审查有关单纯疱疹病毒 (HSV) 角膜炎和其他 HSV 眼病发病率的现有数据，并估计 HSV 眼病的全球负担。方法：我们检索了截至 2020 年 10 月的 Medline 和 Embase 数据库，以获取有关 HSV 眼病发病率的研究报告。使用四点清单评估研究质量。汇总估计值应用于 2016 年人口数据，以估计全球 HSV 眼部疾病负担。通过将公布的风险应用于病例数来估计单眼视力障碍（任何视力 <6/12）的人数。结果：14 项研究有发病率数据；七个符合我们的质量标准。根据 24.0 (95% CI 14.0-41.0; N = 2; I²  = 97.7%) 每 100,000 人年。大多数患有上皮性角膜炎（合并发病率为 16.1/100,000；95% CI 11.6–22.3；N = 3；I ² = 92.6%）。可用的研究很少，仅限于美国和欧洲。HSV 葡萄膜炎和视网膜炎的数据更加有限，尽管这些情况可能共同导致超过 10 万例病例。根据全球发病率，2016 年可能有约 230,000 人新近获得与 HSV 角膜炎相关的单眼视力障碍。结论：每年可能有超过 180 万人患有疱疹性眼病。因此，预防 HSV 感染可能对眼睛健康产生重要影响。疱疹性眼病负担可能被低估了，因为美国和欧洲以外的许多地区 HSV-1 患病率较高且治疗机会较少。