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Epidemiological impact of a genital herpes type 2 vaccine for young females

机译:生殖器疱疹2型疫苗对年轻女性的流行病学影响

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摘要

Genital Herpes, which is caused by Herpes Simplex Virus-1 or -2 (HSV-1, -2, predominantly HSV-2) is a sexually transmitted infection (STI) that causes a chronic latent infection with outbreak episodes linked to transmission. Antiviral therapies are effective in reducing viral shedding during these episodes, but are ineffective as a whole since many outbreaks are asymptomatic or have mild symptoms. Thus, the development of a vaccine for genital herpes is needed to control this disease. The question of how to implement such a vaccine program is an important one, and may be similar to the vaccination program for Human Papilloma Virus (HPV) for young females. We have developed a mathematical model to describe the epidemiology of vaccination targeting young females against HSV-2. The model population is delineated with respect to age group, sexual activity and infection status including oral infection of HSV-1, which may affect vaccine efficacy. A threshold parameter , which determines the level of vaccine uptake needed to eradicate HSV-2, is found. Computer simulation shows that an adolescent-only vaccination program may be effective in eliminating HSV-2 disease, however, the success of extinction greatly depends on the level of vaccine uptake, the vaccine efficacy, the age of sexual maturity and safe sex practices. However, the time course of eradication would take many years. We also investigate the prevalence of infection in the total population and in women between 16–30 years of age before and after vaccination has been introduced, and show that the adolescent-only vaccination program can be effective in reducing disease prevalence in these populations depending on the level of vaccine uptake and vaccine efficacy. This will also result in a decrease of maternal-fetal transmission of HSV-2 infection. Another important, if commonsense, conclusion is that vaccination of some females reduces infection in men, which then reduces infection in women.
机译:生殖器疱疹是由单纯疱疹病毒1或-2(HSV-1,-2,主要是HSV-2)引起的,是一种性传播感染(STI),可引起慢性潜伏感染,并与传播相关。抗病毒疗法可有效减少这些发作期间的病毒脱落,但由于许多疾病爆发无症状或症状较轻,因此整体上无效。因此,需要开发用于生殖器疱疹的疫苗以控制该疾病。如何实施这种疫苗计划的问题是一个重要的问题,可能与针对年轻女性的人乳头瘤病毒(HPV)疫苗接种计划相似。我们已经开发了一个数学模型来描述针对年轻女性针对HSV-2的疫苗接种的流行病学。描述了模型人群的年龄,性活动和感染状况,包括可能影响疫苗效力的HSV-1口腔感染。找到一个阈值参数,该参数确定根除HSV-2所需的疫苗摄取水平。计算机模拟显示,仅青春期的疫苗接种程序可能对消除HSV-2疾病有效,但是,灭绝的成功很大程度上取决于疫苗的摄取水平,疫苗的疗效,性成熟的年龄和安全的性行为。但是,根除的时间过程将需要很多年。我们还调查了在接种疫苗前后,总人群和16-30岁之间的女性中的感染率,并且表明仅青少年疫苗接种计划可以有效降低这些人群中的疾病患病率,具体取决于疫苗摄取水平和疫苗功效。这也将导致HSV-2感染的母婴传播减少。如果是常识,另一个重要的结论是,对某些女性进行疫苗接种可以减少男性的感染,从而减少女性的感染。

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