Key result
Targeting daily antiviral therapy to high-frequency shedders prevents an HSV-2 infection every ~6 person-years.
Why the study?
Classic modeling of sexually transmitted diseases has focused on behavioral heterogeneity and control strategies targeting behavioral core groups, but the role of virological core groups in HSV-2 transmission was not well characterized.
Does daily antiviral therapy targeting virological core groups reduce HSV-2 transmission?
Does daily antiviral therapy targeting virological core groups reduce HSV-2 transmission?
Effect estimate: Median 6.4 person-years to prevent 1 infection
Targeting high-frequency viral shedders with daily antiviral therapy could be an effective public health strategy to substantially reduce HSV-2 transmission.
BACKGROUND: Classic modeling of sexually transmitted diseases has focused on modeling behavioral heterogeneity and designing epidemic control strategies targeted at behavioral core groups. METHODS: We analyzed a new mathematical model of herpes simplex virus type 2 (HSV-2) epidemics that includes virological core groups (i.e., groups of individuals with high rates of viral reactivation) and suggest a new paradigm for epidemic control. We used our model, in conjunction with virological data, to determine the potential role of virological core groups in contributing to transmission and the effect that daily antiviral therapy (DAT) could have on reducing transmission if virological core groups were targeted. RESULTS: We estimated that a virological core group (11% of infected individuals) can cause a disproportionately large percentage (44%) of new infections and that a median of only 6.4 person-years of DAT would be necessary to prevent 1 HSV-2 infection. We determined that relatively few individuals would need to receive DAT to substantially reduce the incidence of HSV-2 infection. CONCLUSION: Identifying and targeting individuals in the virological core group could be an effective and practical public health strategy for reducing transmission. Treating individuals who are high-frequency viral shedders should be evaluated as a strategy for reducing HSV-2 transmission.
No takes yet. Share an insight, caveat, or question.
Blower et al. (2004) studied Herpes simplex virus type 2 (HSV-2). Daily antiviral therapy (DAT) was evaluated on New HSV-2 infections (Median 6.4 person-years to prevent 1 infection). Targeting daily antiviral therapy to a virological core group requires a median of only 6.4 person-years of therapy to prevent 1 HSV-2 infection.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: