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.
Department of Biostatistics, John Wayne Cancer Institute, Santa Monica, CA 90404, United States. simm@jwci.org
Myung Shin K
MS
Sim
William G
WG
Cumberland
Naihua
N
Duan
Yvonne J
YJ
Bryson
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