Vaccine Research Area, FISABIO-Public Health, Avenida de Cataluña, 21, 46020 Valencia, Spain.
Department of Mathematics, Centro Universitario de Plasencia, University of Extremadura, 10600 Plasencia, Spain.
Viruses. 2021 May 13;13(5):906. doi: 10.3390/v13050906.
Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventable with prophylactic HPV vaccination. HPV transmission-dynamic models can predict the potential for the global elimination of cervical cancer. The random network model is a new approach that allows individuals to be followed, and to implement a given vaccination policy according to their clinical records. We developed an HPV transmission-dynamic model on a lifetime sexual partners network based on individual contacts, also accounting for the sexual behavior of men who have sex with men (MSM). We analyzed the decline in the prevalence of HPV infection in a scenario of 75% and 90% coverage for both sexes. An important herd immunity effect for men and women was observed in the heterosexual network, even with 75% coverage. However, HPV infections are persistent in the MSM population, with sustained circulation of the virus among unvaccinated individuals. Coverage around 75% of both sexes would be necessary to eliminate HPV-related conditions in women within five decades. Nevertheless, the variation in the decline in infection in the long term between a vaccination coverage of 75% and 90% is relatively small, suggesting that reaching coverage of around 70-75% in the heterosexual network may be enough to confer high protection. Nevertheless, HPV elimination may be achieved if men's coverage is strictly controlled. This accurate representation of HPV transmission demonstrates the need to maintain high HPV vaccination coverage, especially in men, for whom the cost-effectiveness of vaccination is questioned.
宫颈癌是全世界女性中第四常见的恶性肿瘤，尽管可以通过预防性 HPV 疫苗接种来预防。HPV 传播动力学模型可以预测全球消除宫颈癌的潜力。随机网络模型是一种新方法，可以根据个体的临床记录来跟踪个体，并实施给定的疫苗接种政策。我们在基于个体接触的终生性伴侣网络上开发了一种 HPV 传播动力学模型，同时还考虑了男男性行为者（MSM）的性行为。我们分析了在 75%和 90%的两性疫苗接种覆盖率情景下 HPV 感染率的下降情况。在异性恋网络中，即使覆盖率为 75%，也观察到了男性和女性的重要群体免疫效应。然而，HPV 感染在 MSM 人群中持续存在，未接种疫苗的个体中病毒持续循环。在未来五十年内，要消除女性与 HPV 相关的疾病，需要对两性进行约 75%的覆盖率接种。然而，在 75%和 90%的疫苗接种覆盖率之间，长期感染下降的变化相对较小，这表明在异性恋网络中达到约 70-75%的覆盖率可能足以提供高度保护。然而，如果严格控制男性的覆盖率，可能会实现 HPV 的消除。这种对 HPV 传播的准确描述表明需要维持高 HPV 疫苗接种覆盖率，特别是在男性中，因为男性接种疫苗的成本效益受到质疑。
