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The role of acquired immunity in the spread of human papillomavirus (HPV): explorations with a microsimulation model.


ABSTRACT: 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.

SUBMITTER: Matthijsse SM 

PROVIDER: S-EPMC4314063 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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The role of acquired immunity in the spread of human papillomavirus (HPV): explorations with a microsimulation model.

Matthijsse Suzette M SM   van Rosmalen Joost J   Hontelez Jan A C JA   Bakker Roel R   de Kok Inge M C M IM   van Ballegooijen Marjolein M   de Vlas Sake J SJ  

PloS one 20150202 2


<h4>Background</h4>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.<h4>Methods</h4>We used STDSIM, an established stochastic microsimulation model, quantified to the Netherlands. We explored differ  ...[more]

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