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抗病毒治疗(巴洛沙韦和奥司他韦)对中国季节性流感传播的影响:一项数学建模分析。

Effects of baloxavir and oseltamivir antiviral therapy on the transmission of seasonal influenza in China: A mathematical modeling analysis.

机构信息

School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.

出版信息

J Med Virol. 2022 Nov;94(11):5425-5433. doi: 10.1002/jmv.27969. Epub 2022 Jul 8.

Abstract

New antiviral influenza treatments can effectively alleviate illness while reducing viral shedding. However, how such effects can translate into lower population infections of seasonal influenza in China remains unknown. To shed light on the public health impacts of novel antiviral agents for influenza, we constructed a dynamic transmission model to simulate the seasonal influenza epidemics in China. Two antivirus treatments, baloxavir and oseltamivir, were evaluated by estimating their impacts on the incidences of influenza infection in a single flu season. In the base-case analysis of a 10% antiviral treatment uptake rate, 2760 and 3420 per 10 000 persons contracted influenza under the treatment of baloxavir and oseltamivir, respectively. These incidence rates amounted to an 18.90% relative risk reduction (RRR) of infection associated with baloxavir in relation to oseltamivir. The corresponding RRR was 82.16% when the antiviral treatment uptake rate was increased to 35%. In addition, the peak of the prevalence of infected individuals per 10 000 persons under the baloxavir treatment was 177 (range: 93-274) fewer than that of oseltamivir. Our analyses suggest that the baloxavir treatment strategy reduces the incidence of influenza in China compared with oseltamivir in the setting of a seasonal flu epidemic. Also, increasing the uptake rate of antiviral treatment can potentially prevent millions of infections during a single flu season.

摘要

新型抗流感病毒治疗方法可以有效减轻疾病负担,同时减少病毒脱落。然而,这些治疗方法如何能降低中国季节性流感的人群感染率尚不清楚。为了阐明新型抗流感病毒药物对流感的公共卫生影响,我们构建了一个动态传播模型来模拟中国的季节性流感流行。评估了两种抗病毒药物(巴洛沙韦和奥司他韦),通过估计它们对单季流感感染发生率的影响来评估其效果。在抗病毒治疗使用率为 10%的基本情况分析中,使用巴洛沙韦和奥司他韦治疗的人群中,每 10000 人中分别有 2760 人和 3420 人感染流感。与奥司他韦相比,巴洛沙韦的感染相对风险降低了 18.90%(RRR)。当抗病毒治疗使用率增加到 35%时,相应的 RRR 为 82.16%。此外,使用巴洛沙韦治疗的人群中每 10000 人感染个体的流行高峰比使用奥司他韦的人群低 177 人(范围:93-274)。我们的分析表明,与奥司他韦相比,巴洛沙韦治疗策略可降低中国季节性流感流行期间的流感发病率。此外,增加抗病毒治疗的使用率可能会在单季流感流行期间预防数百万人感染。

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