TY - JOUR
T1 - Cost analysis of treatment strategies for the control of HSV–2 infection in the U.S.
T2 - A mathematical modeling-based case study
AU - Almonte-Vega, Luis
AU - Colón-Vargas, Monica
AU - Luna-Jarrín, Ligia
AU - Martinez, Joel
AU - Rodriguez-Rinc, Jordy
AU - Murillo, Anarina L.
AU - Thakur, Mugdha
AU - Espinoza, Baltazar
AU - Patil, Rohan
AU - Arriola, Leon
AU - Arunachalam, Viswanathan
AU - Mubayi, Anuj
N1 - Funding Information:
The first five authors are undergraduate students and would like to thank Dr. Carlos Castillo-Chavez for giving them the opportunity to participate in the 2018 Mathematical and Theoretical Biology Institute (MTBI) research program where this research was initiated. The MTBI program is housed in the Simon A. Levin Mathematical, Computational and Modeling Sciences Center (Levin Center) at Arizona State University (ASU). The MTBI program is partially supported by grants from the National Science Foundation (NSF Grant MPS-DMS-1263374 and NSF Grant DMS-1757968 ), the National Security Agency (NSA Grant H98230-J8-1-0005 ), the Alfred P. Sloan Foundation, the Office of the President of ASU, and the Office of the Provost of ASU.
Funding Information:
The first five authors are undergraduate students and would like to thank Dr. Carlos Castillo-Chavez for giving them the opportunity to participate in the 2018 Mathematical and Theoretical Biology Institute (MTBI) research program where this research was initiated. The MTBI program is housed in the Simon A. Levin Mathematical, Computational and Modeling Sciences Center (Levin Center) at Arizona State University (ASU). The MTBI program is partially supported by grants from the National Science Foundation (NSF Grant MPS-DMS-1263374and NSF Grant DMS-1757968), the National Security Agency (NSA Grant H98230-J8-1-0005), the Alfred P. Sloan Foundation, the Office of the President of ASU, and the Office of the Provost of ASU.
PY - 2020/6
Y1 - 2020/6
N2 - Infection of Herpes Simplex Virus type 2 (HSV–2) is a lifelong sexually transmitted disease. According to the Center for Disease Control and Prevention (CDC), 11.9% of the United States (U.S.) population was infected with HSV–2 in 2015–2016. The HSV–2 pathogen establishes latent infections in neural cells and can reactivate causing lesions later in life, a strategy that increases pathogenicity and allows the virus to evade the immune system. HSV–2 infections are currently treated by Acyclovir only in the non-constitutional stage, marked by genital skin lesions and ulcers. However, patients in the constitutional stage expressing mild and common (with other diseases) symptoms, such as fever, itching and painful urination, remain difficult to detect and are untreated. In this study, we develop and analyze a mathematical model to study the transmission and control of HSV–2 among the U.S. population between the ages of 15–49 when there are options to treat individuals in different stages of their pathogenicity. In particular, the goals of this work are to study the effect on HSV–2 transmission dynamics and to evaluate and compare the cost-effectiveness of treating HSV–2 infections in both constitutional and non-constitutional stages (new strategy) against the current conventional treatment protocol for treating patients in the non-constitutional stage (current strategy). Our results distinguish model parameter regimes where each of the two treatment strategies can optimize the available resources and consequently gives the long-term reduced cost associated with each treatment and incidence. Moreover, we estimated that the public health cost of HSV–2 with the proposed most cost-effective treatment strategy would increase by approximately 1.63% in 4 years of implementation. However, in the same duration, early treatment via the new strategy will reduce HSV–2 incidence by 42.76% yearly and the reproduction number will decrease to 0.84 from its current estimate of 2.5. Thus, the proposed new strategy will be significantly cost-effective in controlling the transmission of HSV–2 if the strategy is properly implemented.
AB - Infection of Herpes Simplex Virus type 2 (HSV–2) is a lifelong sexually transmitted disease. According to the Center for Disease Control and Prevention (CDC), 11.9% of the United States (U.S.) population was infected with HSV–2 in 2015–2016. The HSV–2 pathogen establishes latent infections in neural cells and can reactivate causing lesions later in life, a strategy that increases pathogenicity and allows the virus to evade the immune system. HSV–2 infections are currently treated by Acyclovir only in the non-constitutional stage, marked by genital skin lesions and ulcers. However, patients in the constitutional stage expressing mild and common (with other diseases) symptoms, such as fever, itching and painful urination, remain difficult to detect and are untreated. In this study, we develop and analyze a mathematical model to study the transmission and control of HSV–2 among the U.S. population between the ages of 15–49 when there are options to treat individuals in different stages of their pathogenicity. In particular, the goals of this work are to study the effect on HSV–2 transmission dynamics and to evaluate and compare the cost-effectiveness of treating HSV–2 infections in both constitutional and non-constitutional stages (new strategy) against the current conventional treatment protocol for treating patients in the non-constitutional stage (current strategy). Our results distinguish model parameter regimes where each of the two treatment strategies can optimize the available resources and consequently gives the long-term reduced cost associated with each treatment and incidence. Moreover, we estimated that the public health cost of HSV–2 with the proposed most cost-effective treatment strategy would increase by approximately 1.63% in 4 years of implementation. However, in the same duration, early treatment via the new strategy will reduce HSV–2 incidence by 42.76% yearly and the reproduction number will decrease to 0.84 from its current estimate of 2.5. Thus, the proposed new strategy will be significantly cost-effective in controlling the transmission of HSV–2 if the strategy is properly implemented.
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U2 - 10.1016/j.mbs.2020.108347
DO - 10.1016/j.mbs.2020.108347
M3 - Article
C2 - 32360294
AN - SCOPUS:85084748132
VL - 324
JO - Mathematical Biosciences
JF - Mathematical Biosciences
SN - 0025-5564
M1 - 108347
ER -