The Role of Acquired Immunity in the Spread of Human Papillomavirus (HPV): Explorations with a Microsimulation Model
| Autor: | Jan A. C. Hontelez, Sake J. de Vlas, Inge M.C.M. de Kok, Marjolein van Ballegooijen, Roel Bakker, Joost van Rosmalen, Suzette M. Matthijsse |
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| Přispěvatelé: | Public Health, Epidemiology |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Uterine Cervical Neoplasms lcsh:Medicine Adaptive Immunity Models Biological Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Young Adult Immune system SDG 3 - Good Health and Well-being Immunity Epidemiology medicine Humans Young adult lcsh:Science education Cervical cancer Human papillomavirus 16 Stochastic Processes education.field_of_study Multidisciplinary Human papillomavirus 18 Transmission (medicine) business.industry Papillomavirus Infections lcsh:R virus diseases Chlamydia Infections Middle Aged Acquired immune system medicine.disease female genital diseases and pregnancy complications Immunology Female lcsh:Q business Research Article |
| Zdroj: | PLoS ONE, Vol 10, Iss 2, p e0116618 (2015) PLoS One, 10 PLoS ONE PLoS One, 10, 2 PLoS One (print), 10(2). Public Library of Science |
| ISSN: | 1932-6203 |
| Popis: | Contains fulltext : 154245.PDF (Publisher’s version ) (Open Access) BACKGROUND: Knowledge of the natural history of human papillomavirus (HPV), in particular the role of immunity, is crucial in estimating the (cost-) effectiveness of HPV vaccination and cervical cancer screening strategies, because naturally acquired immunity after clearing an infection may already protect part of the risk population against new HPV infections. METHODS: We used STDSIM, an established stochastic microsimulation model, quantified to the Netherlands. We explored different assumptions regarding the natural history of HPV-16 and HPV-18, and estimated the transmission probabilities and durations of acquired immunity necessary to reproduce age-specific prevalence. RESULTS: A model without acquired immunity cannot reproduce the age-specific patterns of HPV. Also, it is necessary to assume a high degree of individual variation in the duration of infection and acquired immunity. According to the model estimates, on average 20% of women are immune for HPV-16 and 15% for HPV-18. After an HPV-16 infection, 50% are immune for less than 1 year, whereas 20% exceed 30 years. For HPV-18, up to 12% of the individuals are immune for less than 1 year, and about 50% over 30 years. Almost half of all women will never acquire HPV-16 or HPV-18. CONCLUSIONS: Acquired immunity likely plays a major role in HPV epidemiology, but its duration shows substantial variation. Combined with the lifetime risk, this explains to a large extent why many women will never develop cervical cancer. |
| Databáze: | OpenAIRE |
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