Contact patterns and HPV-genotype interactions yield heterogeneous HPV-vaccine impacts depending on sexual behaviors: An individual-based model
Mélanie Bonneault,
Chiara Poletto,
Maxime Flauder,
Didier Guillemot,
Elisabeth Delarocque-Astagneau,
Anne C.M. Thiébaut,
Lulla Opatowski
Affiliations
Mélanie Bonneault
Epidemiology and Modelling of Antibiotic Evasion Unit, Institut Pasteur, 75475 Paris Cedex 15, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Anti-infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-le-Bretonneux Cedex, France; Université Paris-Saclay, Inserm U1018, CESP, High Dimensional Biostatistics Team, 94807 Villejuif Cedex, France; Correspondence to: Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion Unit, 25, rue du Docteur-Roux, 75475 Paris Cedex 15, France.
Chiara Poletto
Inserm & Sorbonne Université, iPLESP, 75646 Paris, France
Maxime Flauder
Epidemiology and Modelling of Antibiotic Evasion Unit, Institut Pasteur, 75475 Paris Cedex 15, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Anti-infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-le-Bretonneux Cedex, France
Didier Guillemot
Epidemiology and Modelling of Antibiotic Evasion Unit, Institut Pasteur, 75475 Paris Cedex 15, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Anti-infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-le-Bretonneux Cedex, France
Elisabeth Delarocque-Astagneau
Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Anti-infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-le-Bretonneux Cedex, France
Anne C.M. Thiébaut
Université Paris-Saclay, Inserm U1018, CESP, High Dimensional Biostatistics Team, 94807 Villejuif Cedex, France
Lulla Opatowski
Epidemiology and Modelling of Antibiotic Evasion Unit, Institut Pasteur, 75475 Paris Cedex 15, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Anti-infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-le-Bretonneux Cedex, France
Human papillomaviruses are common sexually transmitted infections, caused by a large diversity of genotypes. In the context of vaccination against a subgroup of genotypes, better understanding the role of genotype interactions and human sexual behavior on genotype dynamics is essential. Herein, we present an individual-based model that integrates realistic heterosexual partnership behaviors and simulates interactions between vaccine and non-vaccine genotypes. Genotype interactions were considered, assuming a previous vaccine-genotype infection shortened (competition) or extended (synergy) the duration of a secondary non-vaccine-genotype infection. Sexual behavior determined papillomavirus acquisition and transmission: only 19.5% of active individuals at most 1 partner r during the year, but > 80% of those with ≥ 2 partners, were infected before vaccine introduction. The pre-vaccination situation was consistent with all genotype interaction scenarios. These genotype interactions, despite being undetectable during the pre-vaccination era, markedly impacted genotype prevalence after vaccination started, with a significant increase/decrease of non-vaccine genotypes prevalence for respectively competitive/synergistic interactions. These prevalence changes were more pronounced in individuals with ≤ 3 partners per year (up to 30% of prevalence modification assuming 65% vaccine coverage) but barely visible for individuals with > 3 partners per year (at most 0.30%). Results suggest the presence of genotype interaction, which is consistent with the pre-vaccine situation, may impact the dynamics of non-vaccine genotypes, particularly in less active individuals.
