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faculty: "UvA" and publication year: "2003"
| Authors||W.M. van Ballegooijen, J.A. Bogaards, G.J. Weverling, M.C. Boerlijst, J. Goudsmit|
|Title||AIDS vaccines that allow HIV-1 to infect and escape immunologic control: a mathematical analysis of mass vaccination|
|Journal||Journal of Acquired Immune Deficiency Syndromes|
|Abstract||Cytotoxic T lymphocyte (CTL)-based HIV vaccine concepts shown to reduce |
viremia and postpone disease but not to prevent infection in monkeys are
currently in human phase 1 trials. To evaluate the potential
efficacy of vaccines that cannot prevent HIV-1 to infect and
escape immunologic control, we designed a
mathematic model that correlates the level of viremia to both
infectiousness and disease progression. We
speculate that vaccinees will have a virologic set point and
disease progression rates comparable to
untreated HIV-1-infected individuals with the best prognosis.
Our model (illustrated with R0 = 3) shows
that a sexually active population can ultimately be reduced to
26% of its initial size as a result of
AIDS-related mortality in the absence of treatment or
vaccination. Start of vaccination when HIV-1
prevalence is still low might postpone the peak incidence of
infection and the dramatic decline in population
size by up to 22 years. In conclusion, CTL-based vaccines that
do not prevent HIV-1 infection but do
postpone the time to onset of AIDS have considerable potential
to curb the spread of HIV-1 and to postpone
high AIDS-related mortality on a population level. The number
of long-term survivors is substantially
increased only when vaccination is initiated early in an AIDS
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