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1.
Nat Commun ; 12(1): 6223, 2021 10 28.
Article in English | MEDLINE | ID: covidwho-1510592

ABSTRACT

In 2016 the World Health Organization set the goal of eliminating hepatitis B globally by 2030. Horizontal transmission has been greatly reduced in most countries by scaling up coverage of the infant HBV vaccine series, and vertical transmission is therefore becoming increasingly dominant. Here we show that scaling up timely hepatitis B birth dose vaccination to 90% of new-borns in 110 low- and middle-income countries by 2030 could prevent 710,000 (580,000 to 890,000) deaths in the 2020 to 2030 birth cohorts compared to status quo, with the greatest benefits in Africa. Maintaining this could lead to elimination by 2030 in the Americas, but not before 2059 in Africa. Drops in coverage due to disruptions in 2020 may lead to 15,000 additional deaths, mostly in South-East Asia and the Western Pacific. Delays in planned scale-up could lead to an additional 580,000 deaths globally in the 2020 to 2030 birth cohorts.


Subject(s)
Hepatitis B Vaccines/administration & dosage , Hepatitis B/prevention & control , Africa/epidemiology , Americas/epidemiology , Asia, Southeastern/epidemiology , Disease Eradication/statistics & numerical data , Female , Hepatitis B/epidemiology , Hepatitis B/mortality , Hepatitis B/virology , Hepatitis Viruses/genetics , Hepatitis Viruses/immunology , Humans , Infant , Infant, Newborn , Male , Vaccination , World Health Organization
2.
Epidemiol Infect ; 149: e173, 2021 07 30.
Article in English | MEDLINE | ID: covidwho-1347909

ABSTRACT

New Zealand has a strategy of eliminating SARS-CoV-2 that has resulted in a low incidence of reported coronavirus-19 disease (COVID-19). The aim of this study was to describe the spread of SARS-CoV-2 in New Zealand via a nationwide serosurvey of blood donors. Samples (n = 9806) were collected over a month-long period (3 December 2020-6 January 2021) from donors aged 16-88 years. The sample population was geographically spread, covering 16 of 20 district health board regions. A series of Spike-based immunoassays were utilised, and the serological testing algorithm was optimised for specificity given New Zealand is a low prevalence setting. Eighteen samples were seropositive for SARS-CoV-2 antibodies, six of which were retrospectively matched to previously confirmed COVID-19 cases. A further four were from donors that travelled to settings with a high risk of SARS-CoV-2 exposure, suggesting likely infection outside New Zealand. The remaining eight seropositive samples were from seven different district health regions for a true seroprevalence estimate, adjusted for test sensitivity and specificity, of 0.103% (95% confidence interval, 0.09-0.12%). The very low seroprevalence is consistent with limited undetected community transmission and provides robust, serological evidence to support New Zealand's successful elimination strategy for COVID-19.


Subject(s)
Blood Donors/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Disease Eradication/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Algorithms , Antibodies, Viral/blood , COVID-19/blood , COVID-19/transmission , COVID-19 Serological Testing , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Prevalence , SARS-CoV-2/immunology , Seroepidemiologic Studies , Young Adult
3.
Viruses ; 13(7)2021 07 19.
Article in English | MEDLINE | ID: covidwho-1344395

ABSTRACT

OBJECTIVES: HCV shows complex interactions with lipid metabolism. Our aim was to examine total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) changes in HIV/HCV coinfected patients, after achieving sustained virological response (SVR), according to different HCV genotypes and specific antiretroviral use. METHODS: HIV/HCV coinfected patients, enrolled in the ICONA and HepaICONA cohorts, who achieved DAA-driven SVR were included. Paired t-tests were used to examine whether the pre- and post-SVR laboratory value variations were significantly different from zero. ANCOVA regression models were employed to estimate the causal effect of SVR and of PI/r use on lipid changes. The interaction between the effect of eradication and HCV genotype was formally tested. RESULTS: six hundred and ninety-nine HIV/HCV coinfected patients were enrolled. After HCV eradication, a significant improvement in liver function occurred, with a significant decrease in AST, ALT, GGT, and total plasmatic bilirubin. TC and LDL-C significantly increased by 21.4 mg/dL and 22.4 mg/dL, respectively (p < 0.001), after SVR, whereas there was no evidence for a change in HDL-C (p = 0.45) and triglycerides (p = 0.49). Notably, the TC and LDL-C increase was higher for participants who were receiving darunavir/ritonavir, and the TC showed a more pronounced increase among HCV genotype 3 patients (interaction-p value = 0.002). CONCLUSIONS: complex and rapid changes in TC and LDL-C levels, modulated by HCV genotype and PI/r-based ART combinations, occurred in HIV/HCV coinfected patients after SVR. Further studies are needed to evaluate the clinical impact of these changes on the long-term risk of cardiovascular disease.


Subject(s)
Disease Eradication/statistics & numerical data , HIV Infections/virology , Hepacivirus/genetics , Hepatitis C/prevention & control , Lipid Metabolism , Antiviral Agents/therapeutic use , Cholesterol/blood , Cholesterol, LDL/blood , Cohort Studies , Female , Genotype , Hepacivirus/classification , Hepacivirus/drug effects , Hepatitis C/drug therapy , Humans , Italy , Male , Middle Aged , Sustained Virologic Response
4.
AIDS Res Hum Retroviruses ; 37(8): 585-588, 2021 08.
Article in English | MEDLINE | ID: covidwho-1272954

ABSTRACT

In 2016, the World Health Organization developed a plan for viral hepatitis elimination by 2030. Globally, control of hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most challenging aspects of viral hepatitis elimination. In many developed countries elimination of HBV could be targeted to special populations mostly immigrants from low resource settings. Elimination of HCV, however, remains a challenge globally. Barriers to HCV elimination include high cost of medications and the ability to engage specific at-risk populations as well as individuals who are out of medical care. In the context of the coronavirus disease 2019 (COVID-19) pandemic, treatment access and screening have been further negatively impacted by social distancing rules and COVID-19-related anxieties. This threatens to throw most countries off course in their elimination efforts. Before the pandemic, some states in the United States had scaled up their elimination efforts with plans to ramp up testing and treatment using Netflix-like payment models for HCV direct acting antiviral drugs. Most of these efforts have stalled on account of the health system's focus on COVID-19 control. To prevent further delays in achieving elimination targets, programs would need to explore new models of care that address COVID-19-related access hurdles. Systems that leverage technologies such as telemedicine and self-testing could help maintain treatment levels. Mathematical models estimate that COVID-19-related delays in 2020 could lead to 44,800 hepatocellular cancers and 72,300 liver-related deaths for the next decade.


Subject(s)
COVID-19/epidemiology , Disease Eradication/statistics & numerical data , Hepatitis, Viral, Human/epidemiology , Antiviral Agents/therapeutic use , Goals , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Hepatitis C/epidemiology , Hepatitis, Viral, Human/diagnosis , Hepatitis, Viral, Human/drug therapy , Humans , Pandemics , SARS-CoV-2 , Time Factors
5.
Infect Genet Evol ; 92: 104834, 2021 08.
Article in English | MEDLINE | ID: covidwho-1164211

ABSTRACT

The most important question and concern in these circumstances of COVID-19 epidemic outspread is when will the pandemic end? Vaccination is the only solution to restore life to normalcy in the fastest and safest possible manner. Therefore, we have carried out a predictive analysis for realistic timescale estimates for overcoming the epidemic considering vaccination rate effect on the dynamics of COVID-19 control. In particular we discuss the worst affected large countries like India, Brazil and USA for estimating effect of vaccination rate in expediting the end of the COVID-19 epidemic. We analytically simulated the dynamic evolution of active cases of these countries in the last nine months using the modified SIR model and then included the effect of vaccination to forecast the proliferation dynamics. We hence obtained the transmission parameters, the variation in the reproduction numbers and the impact of the different values of the vaccination shots in the expected curves of active cases in the coming times to predicted the timescales of the end of the epidemic.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/epidemiology , COVID-19/prevention & control , Disease Eradication/statistics & numerical data , SARS-CoV-2 , Brazil/epidemiology , Humans , India/epidemiology , Models, Biological , United States/epidemiology , Vaccination/statistics & numerical data
6.
BMC Med ; 19(1): 2, 2021 01 05.
Article in English | MEDLINE | ID: covidwho-1007167

ABSTRACT

BACKGROUND: Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. FINDINGS: WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. CONCLUSIONS: Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.


Subject(s)
Disease Eradication , Immunization Programs , Immunization, Secondary , Measles , Regional Health Planning/organization & administration , Vaccination Coverage/trends , Africa/epidemiology , Asia, Southeastern/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Disease Eradication/methods , Disease Eradication/statistics & numerical data , Humans , Immunization Programs/methods , Immunization Programs/organization & administration , Immunization, Secondary/methods , Immunization, Secondary/statistics & numerical data , Measles/epidemiology , Measles/prevention & control , Measles Vaccine/therapeutic use , Mediterranean Region/epidemiology , SARS-CoV-2
7.
Am J Prev Med ; 59(4): 493-503, 2020 10.
Article in English | MEDLINE | ID: covidwho-645862

ABSTRACT

INTRODUCTION: Given the continuing COVID-19 pandemic and much of the U.S. implementing social distancing owing to the lack of alternatives, there has been a push to develop a vaccine to eliminate the need for social distancing. METHODS: In 2020, the team developed a computational model of the U.S. simulating the spread of COVID-19 coronavirus and vaccination. RESULTS: Simulation experiments revealed that to prevent an epidemic (reduce the peak by >99%), the vaccine efficacy has to be at least 60% when vaccination coverage is 100% (reproduction number=2.5-3.5). This vaccine efficacy threshold rises to 70% when coverage drops to 75% and up to 80% when coverage drops to 60% when reproduction number is 2.5, rising to 80% when coverage drops to 75% when the reproduction number is 3.5. To extinguish an ongoing epidemic, the vaccine efficacy has to be at least 60% when coverage is 100% and at least 80% when coverage drops to 75% to reduce the peak by 85%-86%, 61%-62%, and 32% when vaccination occurs after 5%, 15%, and 30% of the population, respectively, have already been exposed to COVID-19 coronavirus. A vaccine with an efficacy between 60% and 80% could still obviate the need for other measures under certain circumstances such as much higher, and in some cases, potentially unachievable, vaccination coverages. CONCLUSIONS: This study found that the vaccine has to have an efficacy of at least 70% to prevent an epidemic and of at least 80% to largely extinguish an epidemic without any other measures (e.g., social distancing).


Subject(s)
Communicable Disease Control , Computer Simulation , Coronavirus Infections , Pandemics , Pneumonia, Viral , Vaccination , Viral Vaccines/pharmacology , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Vaccines , Communicable Disease Control/methods , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Eradication/methods , Disease Eradication/statistics & numerical data , Humans , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Treatment Outcome , United States/epidemiology , Vaccination/methods , Vaccination/statistics & numerical data , Vaccination Coverage , Viral Vaccines/standards
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