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      Analysis of a model for hepatitis C virus transmission that includes the effects of vaccination with waning immunity

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          Abstract

          This paper considers a mathematical model based on the transmission dynamics of hepatitis C virus (HCV) infection. In addition to the usual compartments for susceptible, exposed, and infected individuals, this model includes compartments for individuals who are under treatment and those who have had vaccination against HCV infection. It is assumed that the immunity provided by the vaccine fades with time. The basic reproduction number, \(R_0\), and the equilibrium solutions of the model are determined. The model exhibits the phenomenon of backward bifurcation where a stable disease-free equilibrium co-exists with a stable endemic equilibrium whenever \(R_0\) is less than unity. It is shown that the use of only a perfect vaccine can eliminate backward bifurcation completely. Furthermore, a unique endemic equilibrium of the model is proved to be globally asymptotically stable under certain restrictions on the parameter values. Numerical simulation results are given to support the theoretical predictions. [epidemiological model; equilibrium solutions; backward bifurcation; global asymptotic stability; Lyapunov function.]

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          Can antiviral therapy for hepatitis C reduce the prevalence of HCV among injecting drug user populations? A modeling analysis of its prevention utility.

          Hepatitis C virus antiviral treatment is effective for individual patients but few active injecting drug users are treated. We considered the utility of antiviral treatment for primary prevention of hepatitis C. A hepatitis C transmission model among injecting drug users was developed, incorporating treatment (62.5% average sustained viral response) with no retreatment after initial treatment failure, potential re-infection for those cured, equal genotype setting (genotype 1:genotype 2/3), and no immunity. In addition, we examined scenarios with varied treatment response rates, immunity, or retreatment of treatment failures. In the baseline scenario, annually treating 10 infections per 1000 injecting drug users results in a relative decrease in hepatitis C prevalence over 10 years of 31%, 13%, or 7% for baseline (untreated endemic chronic infection) prevalences of 20%, 40%, or 60%, respectively. Sensitivity analyses show that including the potential for immunity has minimal effect on the predictions; prevalence reductions remain even if SVR is assumed to be 25% lower among active IDU than current evidence suggests; retreatment of treatment failures does not alter the short-term (<5 years) projections, but does increase treatment gains within 20 years; hepatitis C free life years gained from treating active injecting drug users are projected to be higher than from treating non-injecting drug users for prevalences below 60%. Despite the possibility of re-infection, modest rates of hepatitis C treatment among active injecting drug users could effectively reduce transmission. Evaluating and extending strategies to treat hepatitis C among active injectors are warranted. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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            Global stability of an epidemic model with latent stage and vaccination

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              Diseases with chronic stage in a population with varying size.

              An epidemiological model of hepatitis C with a chronic infectious stage and variable population size is introduced. A non-structured baseline ODE model which supports exponential solutions is discussed. The normalized version where the unknown functions are the proportions of the susceptible, infected, and chronic individuals in the total population is analyzed. It is shown that sustained oscillations are not possible and the endemic proportions either approach the disease-free or an endemic equilibrium. The expanded model incorporates the chronic age of the individuals. Partial analysis of this age-structured model is carried out. The global asymptotic stability of the infection-free state is established as well as local asymptotic stability of the endemic non-uniform steady state distribution under some additional conditions. A numerical method for the chronic-age-structured model is introduced. It is shown that this numerical scheme is consistent and convergent of first order. Simulations based on the numerical method suggest that in the structured case the endemic equilibrium may be unstable and sustained oscillations are possible. Closer look at the reproduction number reveals that treatment strategies directed towards speeding up the transition from acute to chronic stage in effect contribute to the eradication of the disease.
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                Author and article information

                Journal
                22 December 2017
                Article
                1712.08548
                622af38b-5a13-43d2-85a8-e6e550bbf2f0

                http://arxiv.org/licenses/nonexclusive-distrib/1.0/

                History
                Custom metadata
                23 pages, 4 figures
                q-bio.PE math.DS

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