The potential impact of new tuberculosis vaccines on the burden of tuberculosis in people with HIV in South Africa.

IF 3.4 2区医学 Q3 IMMUNOLOGY AIDS Pub Date : 2025-02-01 Epub Date: 2024-10-10 DOI:10.1097/QAD.0000000000004038

Tom Sumner, Rebecca A Clark, Tomos O Prys-Jones, Roel Bakker, Gavin Churchyard, Richard G White

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Abstract

Background: People with HIV (PWH) are at an increased risk of tuberculosis (TB). New TB vaccines may help reduce this burden. New TB vaccine candidates are well tolerated and immunogenic in PWH. There are currently limited data on vaccine efficacy in this population.

Methods: Using mathematical modeling, we explored the potential impact of a novel TB vaccine on TB burden in PWH in South Africa between 2030 and 2050. We compared the impact of a vaccine delivered irrespective of HIV status to vaccination of either PWH or people without HIV. We explored the impact of reduced vaccine efficacy and duration of protection in PWH relative to people without HIV on our model predictions.

Results: Vaccination irrespective of HIV status, with a vaccine with equal efficacy and duration in PWH, could avert up to 1.01 (95% range: 0.96-1.22) million TB cases in PWH. Restricting vaccination to PWH or people without HIV would achieve 65% (60-70) and 48% (46-53) of the total impact, respectively. These results are strongly dependent on the assumed efficacy and duration of protection in PWH. Further information on these characteristics is important to identify the most efficient use of new vaccines to reduce TB burden in PWH.

Conclusion: Our results suggest that new vaccines could play an important role in reducing the TB burden in PWH. Vaccines targeted at people without HIV could provide significant indirect benefit to PWH, but vaccines which are well tolerated and effective in PWH will be critical to maximizing the impact in this population.

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新型结核病疫苗对南非艾滋病毒感染者结核病负担的潜在影响。

背景：艾滋病毒感染者（PLHIV）罹患结核病（TB）的风险增加。新型结核病疫苗可能有助于减轻这一负担。新型结核病候选疫苗对 PLHIV 安全且具有免疫原性，但目前有关疫苗在该人群中疗效的数据有限：通过数学建模，我们探讨了新型结核病疫苗对 2030-2050 年间南非 PLHIV 中结核病负担的潜在影响。我们比较了不分 HIV 感染状况接种疫苗与为 PLHIV 或未感染 HIV 的人群接种疫苗的影响。我们探讨了相对于未感染 HIV 的人群而言，PLHIV 疫苗疗效和保护期缩短对我们的模型预测的影响：结果：不考虑 HIV 感染状况，在 PLHIV 中接种具有同等效力和持续时间的疫苗，可避免多达 101 万（95% 范围：96-122 万）PLHIV 中的结核病例。将疫苗接种限制在艾滋病毒感染者或未感染艾滋病毒的人群将分别实现总影响的 65% (60-70) 和 48% (46-53)。这些结果在很大程度上取决于对艾滋病毒感染者的假定疗效和保护持续时间。有关这些特征的更多信息对于确定如何最有效地利用新疫苗减轻 PLHIV 的结核病负担非常重要：我们的研究结果表明，新型疫苗可在减轻 PLHIV 的结核病负担方面发挥重要作用。针对未感染艾滋病毒者的疫苗可为 PLHIV 带来巨大的间接益处，但对 PLHIV 安全有效的疫苗对于在这一人群中产生最大影响至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.