Venturino Ezio, Shoukat Affan, Moghadas Seyed M
Dipartimento di Matematica "Giuseppe Peano", Università di Torino, Torino, Italy.
Center for Infectious Disease Modeling and Analysis, School of Public Health, Yale University, CT, USA.
Heliyon. 2020 Jul 15;6(7):e04368. doi: 10.1016/j.heliyon.2020.e04368. eCollection 2020 Jul.
Herpes-Simplex Virus type 2 (HSV-2) is a lifelong infection, which has infected over 400 million individuals aged 15-49 years, worldwide. While the disease can be treated with episodic and suppressive antiviral drugs to reduce the rate of recurrence (i.e., symptomatic disease) and viral shedding, none of the currently available therapies can clear the virus from the body of an infected person. A number of therapeutic vaccine platforms are currently in development in order to achieve similar effects to treatment. Due to the inadequate data from clinical trials of therapeutic vaccines, modeling efforts to quantify the impact of vaccination have been limited. In this study, we propose a compartmental deterministic model for the dynamics of HSV-2 to evaluate the effect of a potential vaccine candidate with the inclusion of a booster dose. Despite its simplicity that may not address the complexity of HSV-2 disease, the model shows that targeting symptomatic infection for vaccination is the most effective strategy in the long-term. This conclusion is based on the assumption of an optimal vaccine efficacy, conferring immunity levels that prevent viral shedding and recurrence transiently. Our model provides a framework for developing a computational system to include more heterogeneous characteristics of the disease and individuals, and investigate effectiveness and cost-effectiveness of vaccination scenarios when clinical data become available.
2型单纯疱疹病毒(HSV-2)是一种终身感染性疾病,在全球范围内,已有超过4亿15至49岁的人感染了该病毒。虽然可以使用间歇性和抑制性抗病毒药物来治疗该疾病,以降低复发率(即出现症状的疾病)和病毒脱落,但目前可用的治疗方法都无法将病毒从感染者体内清除。目前正在开发多种治疗性疫苗平台,以达到与治疗相似的效果。由于治疗性疫苗临床试验的数据不足,量化疫苗接种影响的建模工作受到限制。在本研究中,我们提出了一个关于HSV-2动态变化的房室确定性模型,以评估一种潜在候选疫苗(包括加强剂量)的效果。尽管该模型的简单性可能无法解决HSV-2疾病的复杂性,但该模型表明,从长期来看,针对有症状感染进行疫苗接种是最有效的策略。这一结论基于最佳疫苗效力的假设,即赋予能暂时防止病毒脱落和复发的免疫水平。我们的模型为开发一个计算系统提供了一个框架,该系统可以纳入该疾病和个体的更多异质性特征,并在临床数据可用时研究疫苗接种方案的有效性和成本效益。