Modeling vertical transmission of HIV: imperfect vaccines can be of benefit.
Reducing mother to child transmission (MTCT) of HIV in resource poor countries continues to be a major challenge. Here, we construct a hazard model to assess the effectiveness of combinations of HIV vaccine, Nevirapine (NVP), and HIV-specific monoclonal antibody (HIVAB) in reducing MTCT of HIV during the intrapartum and breastfeeding periods. The model shows that an intervention that uses three doses of vaccine with 30% initial immunity and 30% boost effect with subsequent doses (giving rise to maximum immunity approximately 66% with 3 doses) could reduce MTCT to 7.7% when used with NVP and to 5.9% when used with NVP and HIVAB. Using a vaccine with 50% initial immunity and 50% boost can reduce the rate to 4.3%. These results indicate that even an imperfect vaccine, when used in combination with other therapies, can be of considerable benefit in preventing MTCT in resource poor countries.
Sim
Myung Shin K
MS
Department of Biostatistics, John Wayne Cancer Institute, Santa Monica, CA 90404, United States. simm@jwci.org
Cumberland
William G
WG
Duan
Naihua
N
Bryson
Yvonne J
YJ
D016915:AIDS Vaccines / Q000008:administration & dosage*; D019380:Anti-HIV Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001942:Breast Feeding; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage; D011247:Pregnancy; D016016:Proportional Hazards Models
D016915:AIDS Vaccines; D019380:Anti-HIV Agents; D000911:Antibodies, Monoclonal; D019829:Nevirapine