The future of a partially effective HIV vaccine: assessing limitations at the population level
The future of a partially effective HIV vaccine: assessing limitations at the population level
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DOI：
10.1007/s00038-019-01234-z
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发表时间：
2019-07-01
影响因子：
4.6
通讯作者：
Bershteyn, Anna
中科院分区：
文献类型：
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作者：
Selinger, Christian;Dimitrov, Dobromir T.;Bershteyn, Anna
目标数学模型一致预测，第一代艾滋病毒疫苗的推出将是有用且具有成本效益的，但其总体影响不足以扭转这一流行病。在这里，我们探讨了哪些因素对限制此类疫苗的影响最有影响力。方法从理论上的理想方案到更现实的方案，反映了南非目前正在进行的试验（HVTN 702）中使用的方案，我们对疫苗属性的嵌套层次结构进行了建模，例如扩大规模的速度、功效、耐久性和加强剂量的回报率。 疫苗对艾滋病毒流行的影响主要在于扩大大规模疫苗接种所需的时间、有限的持久性和功效减弱。结论第一代部分有效的疫苗将主要作为一个中间里程碑，提供免疫和平台的相关性，可用于加速未来开发能够逆转艾滋病毒的高效、持久和可扩展的下一代疫苗 流行性。
ObjectivesMathematical models have unanimously predicted that a first-generation HIV vaccine would be useful and cost-effective to roll out, but that its overall impact would be insufficient to reverse the epidemic. Here, we explore what factors contribute most to limiting the impact of such a vaccine.MethodsRanging from a theoretical ideal to a more realistic regimen, mirroring the one used in the currently ongoing trial in South Africa (HVTN 702), we model a nested hierarchy of vaccine attributes such as speed of scale-up, efficacy, durability, and return rates for booster doses.ResultsThe predominant reasons leading to a substantial loss of vaccine impact on the HIV epidemic are the time required to scale up mass vaccination, limited durability, and waning of efficacy.ConclusionsA first-generation partially effective vaccine would primarily serve as an intermediate milestone, furnishing correlates of immunity and platforms that could serve to accelerate future development of a highly effective, durable, and scalable next-generation vaccine capable of reversing the HIV epidemic.