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dc.contributor.authorMarinelli, Isabella
dc.contributor.authorvan Lier, Alies
dc.contributor.authorde Melker, Hester
dc.contributor.authorPugliese, Andrea
dc.contributor.authorvan Boven, Michiel
dc.date.accessioned2018-04-30T12:03:17Z
dc.date.available2018-04-30T12:03:17Z
dc.date.issued2017
dc.identifier.citationEstimation of age-specific rates of reactivation and immune boosting of the varicella zoster virus. 2017, 19:1-12 Epidemicsen
dc.identifier.issn1878-0067
dc.identifier.pmid28007549
dc.identifier.doi10.1016/j.epidem.2016.11.001
dc.identifier.urihttp://hdl.handle.net/10029/621876
dc.description.abstractStudies into the impact of vaccination against the varicella zoster virus (VZV) have increasingly focused on herpes zoster (HZ), which is believed to be increasing in vaccinated populations with decreasing infection pressure. This idea can be traced back to Hope-Simpson's hypothesis, in which a person's immune status determines the likelihood that he/she will develop HZ. Immunity decreases over time, and can be boosted by contact with a person experiencing varicella (exogenous boosting) or by a reactivation attempt of the virus (endogenous boosting). Here we use transmission models to estimate age-specific rates of reactivation and immune boosting, exogenous as well as endogenous, using zoster incidence data from the Netherlands (2002-2011, n=7026). The boosting and reactivation rates are estimated with splines, enabling these quantities to be optimally informed by the data. The analyses show that models with high levels of exogenous boosting and estimated or zero endogenous boosting, constant rate of loss of immunity, and reactivation rate increasing with age (to more than 5% per year in the elderly) give the best fit to the data. Estimates of the rates of immune boosting and reactivation are strongly correlated. This has important implications as these parameters determine the fraction of the population with waned immunity. We conclude that independent evidence on rates of immune boosting and reactivation in persons with waned immunity are needed to robustly predict the impact of varicella vaccination on the incidence of HZ.
dc.language.isoenen
dc.rightsArchived with thanks to Epidemicsen
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAge Factors
dc.subject.meshAged
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshCross-Sectional Studies
dc.subject.meshFemale
dc.subject.meshHerpesvirus 3, Human
dc.subject.meshHumans
dc.subject.meshIncidence
dc.subject.meshInfant
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNetherlands
dc.subject.meshPrevalence
dc.subject.meshVaccination
dc.subject.meshVaricella Zoster Virus Infection
dc.subject.meshYoung Adult
dc.titleEstimation of age-specific rates of reactivation and immune boosting of the varicella zoster virus.en
dc.typeArticleen
dc.identifier.journalEpidemics 2017; 19:1-12en
refterms.dateFOA2018-12-18T14:20:42Z
html.description.abstractStudies into the impact of vaccination against the varicella zoster virus (VZV) have increasingly focused on herpes zoster (HZ), which is believed to be increasing in vaccinated populations with decreasing infection pressure. This idea can be traced back to Hope-Simpson's hypothesis, in which a person's immune status determines the likelihood that he/she will develop HZ. Immunity decreases over time, and can be boosted by contact with a person experiencing varicella (exogenous boosting) or by a reactivation attempt of the virus (endogenous boosting). Here we use transmission models to estimate age-specific rates of reactivation and immune boosting, exogenous as well as endogenous, using zoster incidence data from the Netherlands (2002-2011, n=7026). The boosting and reactivation rates are estimated with splines, enabling these quantities to be optimally informed by the data. The analyses show that models with high levels of exogenous boosting and estimated or zero endogenous boosting, constant rate of loss of immunity, and reactivation rate increasing with age (to more than 5% per year in the elderly) give the best fit to the data. Estimates of the rates of immune boosting and reactivation are strongly correlated. This has important implications as these parameters determine the fraction of the population with waned immunity. We conclude that independent evidence on rates of immune boosting and reactivation in persons with waned immunity are needed to robustly predict the impact of varicella vaccination on the incidence of HZ.


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