AIDS vaccines that allow HIV-1 to infect and escape immunologic control: A mathematic analysis of mass vaccination

Johannes A. Bogaards, Marijn Van Ballegooijen, Gerrit Jan Weverling, Maarten C. Boerlijst, Jaap Goudsmit*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Cytotoxic T lymphocyte (CTL)-based HIV vaccine concepts shown to reduce viremia and postpone disease but not to prevent infection in monkeys are currently in human phase 1 trials. To evaluate the potential efficacy of vaccines that cannot prevent HIV-1 to infect and escape immunologic control, we designed a mathematic model that correlates the level of viremia to both infectiousness and disease progression. We speculate that vaccinees will have a virologic set point and disease progression rates comparable to untreated HIV-1-infected individuals with the best prognosis. Our model (illustrated with R0 = 3) shows that a sexually active population can ultimately be reduced to 26% of its initial size as a result of AIDS-related mortality in the absence of treatment or vaccination. Start of vaccination when HIV-1 prevalence is still low might postpone the peak incidence of infection and the dramatic decline in population size by up to 22 years. In conclusion, CTL-based vaccines that do not prevent HIV-1 infection but do postpone the time to onset of AIDS have considerable potential to curb the spread of HIV-1 and to postpone high AIDS-related mortality on a population level. The number of long-term survivors is substantially increased only when vaccination is initiated early in an AIDS epidemic, however.

Original languageEnglish
Pages (from-to)214-220
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number2
Publication statusPublished - 1 Oct 2003

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