Prevalence of CMV, EBV, HPV, and HSV among South Asian healthy population: A systematic review and meta-analysis

TL;DR

This study finds that 20% of healthy people in South Asia are infected with one of four common DNA viruses, highlighting the need for awareness and prevention.

Contribution

The study provides the first pooled prevalence estimates of CMV, EBV, HPV, and HSV among healthy South Asian populations.

Findings

The overall pooled prevalence of CMV, EBV, HPV, and HSV among healthy South Asians is 20%.

CMV had the highest pooled prevalence at 57%, followed by EBV at 17%, HPV at 13%, and HSV at 9%.

India contributed the majority of the studies included in the analysis.

Abstract

Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Human papillomavirus (HPV), and Herpes simplex virus (HSV) are DNA viruses which are highly prevalent among the general population. Although the prevalence of each of these viruses has been studied separately within South Asian populations, there are no studies regarding the pooled prevalence of these viruses among healthy individuals across South Asia. A systematic search was performed using three databases (PubMed, Scopus, and Cochrane Library) and one search engine (Google Scholar) for original studies on the South Asian population (published from 2000 to 2025). Following the search, DerSimonian-Laird random effect meta-analysis was performed to calculate the overall prevalence of CMV, EBV, HPV, and HSV in South Asia. Based on our eligibility criteria, we found 94 studies from 7 South Asian countries comprising 162,659 healthy individuals. The overall pooled prevalence of the four viruses was 20% [95% CI: 16% to 24%]. The prevalence of the studies ranged from 0% to 100% indicating a significant amount of heterogeneity (I2 = 100%; p < 0.01). The highest pooled prevalence was of CMV (57%; 95% CI: 21% to 89%) followed by EBV (17%; 95% CI: 5% to 34%), HPV (13%; 95% CI: 10%. to 16%), and HSV (9%; 95% CI: 16% to 12%). Furthermore, country-wise analysis showed India to have the majority of the studies. Our findings revealed that 20% [95% CI: 16% to 24%] of healthy individuals who lived in different South Asian countries are infected with one of these DNA viruses, emphasizing the widespread impact across different geographical regions. As these infections can lead to severe health complications, it is crucial to establish preventive guidelines and spread awareness among the healthy population.

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