Effectiveness of UNAIDS targets and HIV vaccination across 127 countries
Effectiveness of UNAIDS targets and HIV vaccination across 127 countries
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DOI：
10.1073/pnas.1620788114
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发表时间：
2017-04-11
影响因子：
11.1
通讯作者：
Galvani, Alison P.
中科院分区：
文献类型：
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作者：
Medlock, Jan;Pandey, Abhishek;Galvani, Alison P.
艾滋病毒流行病继续在地球仪造成巨大的发病率、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正在为“以治为主”和“预防为主”提供新工具。我们开发了一个数学模型来评估艾滋病毒疫苗在127个国家提高诊断率、治疗率和病毒抑制率的目标背景下的额外益处。在现状干预下，我们预测从2015年到2035年，全球范围内的中位数为4900万[第一和第三四分位数为44 M，58 M]。实现联合国艾滋病毒/艾滋病联合规划署95-95-95的目标估计可避免2500万[20 M，33 M]的新感染，预计到2020年，随着50%效力的疫苗逐步扩大到70%的覆盖率，还将减少630万[48 M，87 M]。通过接种疫苗预防的这一额外好处促使即将进行和正在进行的可行候选人临床试验，以实现艾滋病毒控制的目标。
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.