Hepatitis-B virus endemicity: heterogeneity, catastrophic dynamics and control


Medley, GF; Lindop, NA; Edmunds, WJ; Nokes, DJ; (2001) Hepatitis-B virus endemicity: heterogeneity, catastrophic dynamics and control. Nature medicine, 7 (5). pp. 619-24. ISSN 1078-8956 DOI: https://doi.org/10.1038/87953

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Abstract

Hepatitis-B virus infection is globally ubiquitous, but its distribution is very heterogeneous, with prevalence of serological markers in various nations ranging from less than 1% to more than 90%. We propose an explanation for this diversity using a mathematical model of hepatitis-B virus transmission dynamics that shows, for the first time, 'catastrophic' behavior using realistic epidemiological processes and parameters. Our major conclusion is that the prevalence of infection is largely determined by a feedback mechanism that relates the rate of transmission, average age at infection and age-related probability of developing carriage following infection. Using the model we identify possible, highly non-linear, consequences of chemotherapy and immunization interventions, for which the starting prevalence of carriers is the most influential, predictive quantity. Taken together, our results demand a re-evaluation of public health policy towards hepatitis-B.

Item Type: Article
Keywords: Carrier State, Hepatitis B/*epidemiology/virology, Humans, Prevalence, Carrier State, Hepatitis B, epidemiology, virology, Humans, Prevalence
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 11329065
Web of Science ID: 169961100043
URI: http://researchonline.lshtm.ac.uk/id/eprint/6773

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