Modeling the Impact of Potential Vaccines on Epidemics of Sexually Transmitted Chlamydia trachomatis Infection
Modeling the Impact of Potential Vaccines on Epidemics of Sexually Transmitted Chlamydia trachomatis Infection
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DOI：
10.1086/598983
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发表时间：
2009-06-01
影响因子：
6.4
通讯作者：
Wilson, David P.
中科院分区：
文献类型：
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作者：
Gray, Richard T.;Beagley, Kenneth W.;Wilson, David P.
背景我们调查了疫苗对异性恋人群中沙眼衣原体（衣原体）感染的患病率和发病率的可能影响。一个基于个体的数学模型的衣原体传播的衣原体感染的个人的感染过程中的开发和链接。该模型通过疫苗对感染易感个体所需的衣原体负荷（“临界负荷”）、感染个体的负荷及其随后的传染性的影响来描述疫苗的影响。使用行为学、生物学和临床数据对模型进行校准。在初次性行为前接种一种完全保护性的衣原体疫苗，理论上可以在20年内消除衣原体流行。部分有效的疫苗仍然可以大大降低衣原体感染的发生率。疫苗的主要目的是增加易感个体的临界负荷，其次是减少接种疫苗后感染个体的峰值负荷和/或感染持续时间。两性接种对衣原体相关的发病率有有益的影响，但针对女性比针对男性更有效。我们的研究结果可用于实验室环境，以评估动物模型中的候选疫苗，监管机构在促进临床试验的候选人，并由公共卫生当局在决定最佳干预策略。
Background. We investigated the likely impact of vaccines on the prevalence of and morbidity due to Chlamydia trachomatis (chlamydia) infections in heterosexual populations.Methods. An individual-based mathematical model of chlamydia transmission was developed and linked to the infection course in chlamydia-infected individuals. The model describes the impact of a vaccine through its effect on the chlamydial load required to infect susceptible individuals (the "critical load"), the load in infected individuals, and their subsequent infectiousness. The model was calibrated using behavioral, biological, and clinical data.Results. A fully protective chlamydia vaccine administered before sexual debut can theoretically eliminate chlamydia epidemics within 20 years. Partially effective vaccines can still greatly reduce the incidence of chlamydia infection. Vaccines should aim primarily to increase the critical load in susceptible individuals and secondarily to decrease the peak load and/or the duration of infection in vaccinated individuals who become infected. Vaccinating both sexes has a beneficial impact on chlamydia-related morbidity, but targeting women is more effective than targeting men.Conclusions. Our findings can be used in laboratory settings to evaluate vaccine candidates in animal models, by regulatory bodies in the promotion of candidates for clinical trials, and by public health authorities in deciding on optimal intervention strategies.