Department of Biomedical Sciences, Oregon State University, Corvallis, OR 97331-4801;
Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06510-2483.
Proc Natl Acad Sci U S A. 2017 Apr 11;114(15):4017-4022. doi: 10.1073/pnas.1620788114. Epub 2017 Mar 20.
The HIV pandemic continues to impose enormous morbidity, mortality, and economic burdens across the globe. Simultaneously, innovations in antiretroviral therapy, diagnostic approaches, and vaccine development are providing novel tools for treatment-as-prevention and prophylaxis. We developed a mathematical model to evaluate the added benefit of an HIV vaccine in the context of goals to increase rates of diagnosis, treatment, and viral suppression in 127 countries. Under status quo interventions, we predict a median of 49 million [first and third quartiles 44M, 58M] incident cases globally from 2015 to 2035. Achieving the Joint United Nations Program on HIV/AIDS 95-95-95 target was estimated to avert 25 million [20M, 33M] of these new infections, and an additional 6.3 million [4.8M, 8.7M] reduction was projected with the 2020 introduction of a 50%-efficacy vaccine gradually scaled up to 70% coverage. This added benefit of prevention through vaccination motivates imminent and ongoing clinical trials of viable candidates to realize the goal of HIV control.
艾滋病毒大流行继续在全球造成巨大的发病率、死亡率和经济负担。与此同时，抗逆转录病毒疗法、诊断方法和疫苗开发方面的创新为治疗即预防和预防提供了新的工具。我们开发了一个数学模型，以评估在提高 127 个国家的诊断、治疗和病毒抑制率目标的背景下，艾滋病毒疫苗的额外益处。在现状干预下，我们预测 2015 年至 2035 年期间全球将有 4900 万[第一和第三四分位数 4400 万，5800 万]例新发病例。实现联合国艾滋病规划署 95-95-95 目标估计可避免 2500 万[2000 万，3300 万]例新感染，到 2020 年，若引入一种 50%有效率的疫苗，并逐步扩大到 70%的覆盖率，预计还将减少 630 万[480 万，870 万]例。疫苗预防的这种额外益处促使人们立即开展和继续开展可行候选疫苗的临床试验，以实现艾滋病毒控制的目标。
