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Jain S, Vimal N, Angmo N, Sengupta M, Thangaraj S. Dengue Vaccination: Towards a New Dawn of Curbing Dengue Infection. Immunol Invest 2023; 52:1096-1149. [PMID: 37962036 DOI: 10.1080/08820139.2023.2280698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Dengue is an infectious disease caused by dengue virus (DENV) and is a serious global burden. Antibody-dependent enhancement and the ability of DENV to infect immune cells, along with other factors, lead to fatal Dengue Haemorrhagic Fever and Dengue Shock Syndrome. This necessitates the development of a robust and efficient vaccine but vaccine development faces a number of hurdles. In this review, we look at the epidemiology, genome structure and cellular targets of DENV and elaborate upon the immune responses generated by human immune system against DENV infection. The review further sheds light on various challenges in development of a potent vaccine against DENV which is followed by presenting a current account of different vaccines which are being developed or have been licensed.
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Affiliation(s)
- Sidhant Jain
- Independent Researcher, Institute for Globally Distributed Open Research and Education (IGDORE), Rewari, India
| | - Neha Vimal
- Bhaskaracharya College of Applied Sciences, University of Delhi, Delhi, India
| | - Nilza Angmo
- Maitreyi College, University of Delhi, Delhi, India
| | - Madhumita Sengupta
- Janki Devi Bajaj Government Girls College, University of Kota, Kota, India
| | - Suraj Thangaraj
- Swami Ramanand Teerth Rural Government Medical College, Maharashtra University of Health Sciences, Ambajogai, India
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da Silva PG, Chaves EJF, Silva TMS, Rocha GB, Dantas WM, de Oliveira RN, Pena LJ. Antiviral Activity of Flavonoids from Geopropolis of the Brazilian Jandaira Bee against Zika and Dengue Viruses. Pharmaceutics 2023; 15:2494. [PMID: 37896254 PMCID: PMC10609720 DOI: 10.3390/pharmaceutics15102494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 10/29/2023] Open
Abstract
Arthropod-borne viruses within the Flaviviridae family such as Zika (ZIKV) and dengue (DENV) are responsible for major outbreaks in tropical countries, and there are no specific treatments against them. Naringenin and 7-O-methyl naringenin are flavonoids that can be extracted from geopropolis, a natural material that the Brazilian Jandaira stingless bee (Melipona subnitida Ducke) produces to protect its nest. Here, these flavonoids were tested against ZIKV and DENV using Vero cells as a cellular model to perform a cytotoxicity assay and to define the effective concentrations of TCID50 as the readout method. The results demonstrated the antiviral activity of the compounds against both viruses upon the treatment of infected cells. The tested flavonoids had antiviral activity comparable with 6-methylmercaptopurine riboside (6-MMPr), used here as a positive control. In addition, to identify the possible action mechanism of the antiviral candidates, we carried out a docking analysis followed by a molecular dynamics simulation to elucidate naringenin and 7-O-methyl naringenin binding sites to each virus. Altogether, these results demonstrate that both flavonoids have potent antiviral effects against both viruses and warrant further in vivo trials.
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Affiliation(s)
- Poliana Gomes da Silva
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife 50670-420, Pernambuco, Brazil; (P.G.d.S.); (E.J.F.C.); (W.M.D.)
| | - Elton José Ferreira Chaves
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife 50670-420, Pernambuco, Brazil; (P.G.d.S.); (E.J.F.C.); (W.M.D.)
| | - Tania Maria Sarmento Silva
- Phytochemical Bioprospecting Laboratory, Department of Chemistry, Federal Rural University of Pernambuco, Recife 52171-900, Pernambuco, Brazil;
| | - Gerd Bruno Rocha
- Laboratory of Computational Quantum Chemistry, Department of Chemistry, Federal University of Paraiba, João Pessoa 58050-085, Paraiba, Brazil;
| | - Willyenne Marília Dantas
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife 50670-420, Pernambuco, Brazil; (P.G.d.S.); (E.J.F.C.); (W.M.D.)
- Bioactive Compounds Synthesis Laboratory, Department of Chemistry, Federal Rural University of Pernambuco (UFRPE), Recife 52171-900, Pernambuco, Brazil;
| | - Ronaldo Nascimento de Oliveira
- Bioactive Compounds Synthesis Laboratory, Department of Chemistry, Federal Rural University of Pernambuco (UFRPE), Recife 52171-900, Pernambuco, Brazil;
| | - Lindomar José Pena
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife 50670-420, Pernambuco, Brazil; (P.G.d.S.); (E.J.F.C.); (W.M.D.)
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Thisyakorn U, Saokaew S, Gallagher E, Kastner R, Sruamsiri R, Oliver L, Hanley R. Epidemiology and costs of dengue in Thailand: A systematic literature review. PLoS Negl Trop Dis 2022; 16:e0010966. [PMID: 36534668 PMCID: PMC9810168 DOI: 10.1371/journal.pntd.0010966] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 01/03/2023] [Accepted: 11/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dengue is the fastest-spreading vector-borne viral disease worldwide. In Thailand, dengue is endemic and is associated with a high socioeconomic burden. A systematic literature review was conducted to assess and describe the epidemiological and economic burden of dengue in Thailand. METHODS Epidemiological and economic studies published in English and Thai between 2011-2019 and 2009-2019, respectively, were searched in MEDLINE, Embase, and Evidence-Based Medicines reviews databases. Reports published by the National Ministry of Public Health (MoPH) and other grey literature sources were also reviewed. Identified studies were screened according to predefined inclusion and exclusion criteria. Extracted data were descriptively summarised and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A total of 155 publications were included in the review (39 journal articles and 116 grey literature). Overall, dengue incidence varied yearly, with the highest rates per 100,000 population in 2013 (dengue fever (DF) 136.6, dengue haemorrhagic fever (DHF) 100.9, dengue shock syndrome (DSS) 3.58) and 2015 (DF 133.1, DHF 87.4, DSS 2.14). Peak incidence coincided with the monsoon season, and annual mortality was highest for DSS, particularly in the age group 15-24-year-olds. The highest dengue incidence rates were reported in children (10-14-year-olds) and young adults (15-24-year-olds), irrespective of dengue case definition. Economic and societal burdens are extensive, with the average cost per case ranging from USD 41 to USD 261, total cost per year estimated at USD 440.3 million, and an average of 7.6 workdays lost for DHF and 6.6 days for DF. CONCLUSIONS The epidemiological, economic, and societal burden of dengue in Thailand is high and underreported due to gaps in national surveillance data. The use of expansion factors (EFs) is recommended to understand the true incidence of dengue and cost-benefit of control measures. Furthermore, as dengue is often self-managed and underreported, lost school and workdays result in substantial underestimation of the true economic and societal burden of dengue. The implementation of integrated strategies, including vaccination, is critical to reduce the disease burden and may help alleviate health disparities and equity challenges posed by dengue.
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Affiliation(s)
- Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Surasak Saokaew
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
- Unit of Excellence on Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
- Division of Social and Administrative Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | | | - Randee Kastner
- Takeda Vaccines Inc., Cambridge, Massachusetts, United States of America
| | | | - Louisa Oliver
- Adelphi Values, Bollington, Macclesfield, United Kingdom
| | - Riona Hanley
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
- * E-mail:
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Thommes E, Coudeville L, Muhammad R, Martin M, Nelson CB, Chit A. Public health impact and cost-effectiveness of implementing a 'pre-vaccination screening' strategy with the dengue vaccine in Puerto Rico. Vaccine 2022; 40:7343-7351. [PMID: 36347720 DOI: 10.1016/j.vaccine.2022.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommended 'pre-vaccination screening' as its preferred implementation strategy when using the licensed dengue vaccine (CYD-TDV; Dengvaxia, Sanofi), so that only individuals with previous dengue infection are vaccinated. The US Centers for Disease Control and Prevention (CDC) recommended use of CYD-TDV to prevent dengue in children with previous laboratory-confirmed dengue infection in regions where dengue is endemic. Here, we evaluate the public health impact and cost-effectiveness of a 'pre-vaccination screening' strategy in Puerto Rico. METHODS The current analysis builds upon a previously published transmission model used to assess the benefits/risks associated with dengue vaccination. For 'pre-vaccination screening', three alternative testing methods were assessed: one using an immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) dengue serotest, another with dengue serotesting using a rapid diagnostic test (RDT), and one using both sequentially (as recommended in Puerto Rico). The time horizon considered was 10 years. RESULTS In Puerto Rico, the disability-adjusted life years (DALYs) averted for 'pre-vaccination screening' with an ELISA-based program, RDT-based program, and both sequentially would be a median 1,192 (95% CI: 716-2,232), 2,812 (95% CI: 1,579-5,019), and 1,017 (95% CI: 561-1,738), respectively. These benefits would arise from the reduction in cases: median 24,961 (95% CI: 17,480-36,782), 58,273 (95% CI: 40,729-84,796), 20,775 (95% CI: 14,637-30,374) fewer cases, respectively. The cost per DALY averted from a payer perspective would be US$12,518 (95 %CI: US$4,749-26,922), US$10,047 (95% CI: US$3,350-23,852), and US$12,334 (95% CI: US$4,965-26,444), respectively. All three strategies would be cost saving from a societal perspective. CONCLUSIONS Our study supports the WHO and CDC 'pre-vaccination screening' guidance for CYD-TDV implementation. In Puerto Rico, regardless of the testing strategy and even with a relatively low rate of testing, it would be cost-effective from a payer perspective and cost saving from a societal perspective.
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Affiliation(s)
- Edward Thommes
- Sanofi, 1755 Steeles Avenue W, Toronto, Ontario M2R 3T4, Canada; University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada; York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
| | | | | | - Maria Martin
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA.
| | | | - Ayman Chit
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.
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AbuBakar S, Puteh SEW, Kastner R, Oliver L, Lim SH, Hanley R, Gallagher E. Epidemiology (2012-2019) and costs (2009-2019) of dengue in Malaysia: a systematic literature review. Int J Infect Dis 2022:S1201-9712(22)00505-7. [PMID: 36089149 DOI: 10.1016/j.ijid.2022.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/10/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A systematic literature review was conducted to assess the epidemiology and economic burden of dengue in Malaysia. METHODS Embase, MEDLINE, Evidence-Based Reviews databases, and grey literature sources were searched for English and Malay studies and surveillance reports on the epidemiology (between 2012-2019) and costs (between 2009-2019) of dengue in Malaysia. Independent screening of titles/abstracts followed by full texts was performed using pre-specified criteria. RESULTS A total of 198 publications were included (55 peer-reviewed and 143 grey literature). Dengue incidence has been increasing in recent years, with 130,101 cases (dengue fever [DF] 129,578 cases; dengue haemorrhagic fever [DHF] 523 cases) reported in 2019, which is the highest since 2012. All DENV serotypes co-circulated between 2004 and 2017, and major outbreaks occurred in a cyclical pattern, often associated with a change in the predominant circulating serotype. Economic impacts are substantial, including the societal impact of lost work (7.2-8.8 days) and school days (3.2-4.1 days) due to dengue. CONCLUSIONS The rising incidence and high cost of dengue, coupled with overlapping diseases, will likely result in further pressures on the healthcare system. To appropriately mitigate and control dengue, it is critical to implement integrated strategies, including vaccination, to reduce the burden of dengue.
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Arham AF, Amin L, Mustapa MAC, Mahadi Z, Yaacob M, Arham AF, Norizan NS. "To do, or not to do?": determinants of stakeholders' acceptance on dengue vaccine using PLS-SEM analysis in Malaysia. BMC Public Health 2022; 22:1574. [PMID: 35982443 DOI: 10.1186/s12889-022-13967-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Dengue vaccine is a promising alternative for protecting communities from dengue. Nevertheless, public acceptance of the dengue vaccine must be considered before the authorities decide to carry out intensified research and recommend the vaccine adoption. This study aimed to assess the stakeholders' acceptability of the dengue vaccine and determine the factors that influence their intentions to adopt it. Methods Survey data collected from 399 respondents who represented two primary stakeholder groups: scientist (n = 202) and public (n = 197), were analysed using the partial least squares-structural equation modelling (PLS-SEM) technique. Results The findings revealed that the stakeholders claimed to have a highly positive attitude and intention to adopt the vaccine, perceived the vaccine as having high benefits, and displayed a high degree of religiosity and trust in the key players. The results also demonstrated that attitude and perceived benefits significantly influenced the intention to adopt the dengue vaccine. Furthermore, the perceived benefit was the most significant predictor of attitude to the dengue vaccine, followed by religiosity, attitudes to technology, and trust in key players. Conclusion The findings showed that the stakeholders in Malaysia were optimistic about the dengue vaccine with a positive attitude and perceived benefits as significant predictors of intention to adopt the vaccine. Hence, ongoing research can be intensified with the end target of recommending the vaccine for public adoption in hotspot areas. This finding contributes to the consumer behaviour literature while also providing helpful information to the government, policymakers, and public health officials about effective strategies for driving dengue vaccine acceptance in Malaysia and other countries with a history of severe dengue transmission.
Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13967-3.
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Junior JBS, Massad E, Lobao-Neto A, Kastner R, Oliver L, Gallagher E. Epidemiology and costs of dengue in Brazil: a systematic literature review. Int J Infect Dis 2022; 122:521-528. [DOI: 10.1016/j.ijid.2022.06.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
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Chamnan A, Pongsumpun P, Tang I, Wongvanich N. Effect of a Vaccination against the Dengue Fever Epidemic in an Age Structure Population: From the Perspective of the Local and Global Stability Analysis. Mathematics 2022; 10:904. [DOI: 10.3390/math10060904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The effect of vaccination on the dengue fever epidemic described by an age structured modified SIR (Susceptible-Infected-Retired) model is studied using standard stability analysis. The chimeric yellow fever dengue tetravalent dengue vaccine (CYD-TDV™) is a vaccine recently developed to control this epidemic in several Southeast Asian countries. The dengue vaccination program requires a total of three injections, 6 months apart at 0, 6, and 12 months. The ages of the recipients are nine years and above. In this paper, we analyze the mathematical dynamics SIR transmission model of the epidemic. The stability of the model is established using Routh–Hurwitz criteria to see if a Hopf Bifurcation occurs and see when the equilibrium states are local asymptotically stable or global asymptotically stable. We have determined the efficiency of CYD-TDV by simulating the optimal numerical solution for each age range for this model. The numerical results showed the optimal age for vaccination and significantly reduced the severity and severity of the disease.
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Yang SNY, Maher B, Wang C, Wagstaff KM, Fraser JE, Jans DA. High Throughput Screening Targeting the Dengue NS3-NS5 Interface Identifies Antivirals against Dengue, Zika and West Nile Viruses. Cells 2022; 11:730. [PMID: 35203378 PMCID: PMC8870125 DOI: 10.3390/cells11040730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/03/2022] [Accepted: 02/11/2022] [Indexed: 12/04/2022] Open
Abstract
Dengue virus (DENV) threatens almost 70% of the world's population, with no effective therapeutic currently available and controversy surrounding the one approved vaccine. A key factor in dengue viral replication is the interaction between DENV nonstructural proteins (NS) 5 and 3 (NS3) in the infected cell. Here, we perform a proof-of-principle high-throughput screen to identify compounds targeting the NS5-NS3 binding interface. We use a range of approaches to show for the first time that two small molecules-repurposed drugs I-OMe tyrphostin AG538 (I-OMe-AG238) and suramin hexasodium (SHS)-inhibit NS5-NS3 binding at low μM concentration through direct binding to NS5 that impacts thermostability. Importantly, both have strong antiviral activity at low μM concentrations against not only DENV-2, but also Zika virus (ZIKV) and West Nile virus (WNV). This work highlights the NS5-NS3 binding interface as a viable target for the development of anti-flaviviral therapeutics.
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Affiliation(s)
| | | | | | | | | | - David A. Jans
- Nuclear Signalling Laboratory, Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Monash, VIC 3800, Australia; (S.N.Y.Y.); (B.M.); (C.W.); (K.M.W.); (J.E.F.)
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Pinheiro-Michelsen JR, Souza RDSO, Santana IVR, da Silva PDS, Mendez EC, Luiz WB, Amorim JH. Anti-dengue Vaccines: From Development to Clinical Trials. Front Immunol 2020; 11:1252. [PMID: 32655561 PMCID: PMC7325986 DOI: 10.3389/fimmu.2020.01252] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/18/2020] [Indexed: 12/19/2022] Open
Abstract
Dengue Virus (DENV) is an arbovirus (arthropod-borne virus). Four serotypes of DENV are responsible for the infectious disease called dengue that annually affects nearly 400 million people worldwide. Although there is only one vaccine formulation licensed for use in humans, there are other vaccine formulations under development that apply different strategies. In this review, we present information about anti-dengue vaccine formulations regarding development, pre-clinical tests, and clinical trials. The improvement in vaccine development against dengue is much needed, but it should be considered that the correlate of protection is still uncertain. Neutralizing antibodies have been proposed as a correlate of protection, but this ignores the key role of T-cell mediated immunity in controlling DENV infection. It is important to confirm the accurate correlate of protection against DENV infection, and also to have other anti-dengue vaccine formulations licensed for use.
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Affiliation(s)
- Josilene Ramos Pinheiro-Michelsen
- Laboratório de Agentes Infecciosos e Vetores, Centro das Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Brazil.,Programa de Pós-graduação em Biologia e Biotecnologia de Microrganismos, Universidade Estadual de Santa Cruz, Barreiras, Brazil
| | - Rayane da Silva Oliveira Souza
- Laboratório de Agentes Infecciosos e Vetores, Centro das Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Brazil
| | - Itana Vivian Rocha Santana
- Laboratório de Agentes Infecciosos e Vetores, Centro das Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Brazil
| | - Patrícia de Souza da Silva
- Laboratório de Agentes Infecciosos e Vetores, Centro das Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Brazil.,Programa de Pós-graduação em Biologia e Biotecnologia de Microrganismos, Universidade Estadual de Santa Cruz, Barreiras, Brazil
| | - Erick Carvalho Mendez
- Programa de Pós-graduação em Biologia e Biotecnologia de Microrganismos, Universidade Estadual de Santa Cruz, Barreiras, Brazil
| | - Wilson Barros Luiz
- Programa de Pós-graduação em Biologia e Biotecnologia de Microrganismos, Universidade Estadual de Santa Cruz, Barreiras, Brazil
| | - Jaime Henrique Amorim
- Laboratório de Agentes Infecciosos e Vetores, Centro das Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Brazil.,Programa de Pós-graduação em Biologia e Biotecnologia de Microrganismos, Universidade Estadual de Santa Cruz, Barreiras, Brazil
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Coudeville L, Baurin N, Shepard DS. The potential impact of dengue vaccination with, and without, pre-vaccination screening. Vaccine 2019; 38:1363-1369. [PMID: 31879126 DOI: 10.1016/j.vaccine.2019.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The World Health Organization defined a 'screen and vaccinate' strategy as its recommended policy for the licensed dengue vaccine (Dengvaxia, Sanofi Pasteur), so that only individuals with previous dengue infection are vaccinated. The objectives of the present study were to build upon a recently published analysis of the benefits and risks associated with dengue vaccination to evaluate the public health impact and cost-effectiveness of a screen and vaccinate strategy. METHODS The current analysis was based on a previously reported transmission model and added, for the screening part, three rapid diagnostic tests with identical specificity (99%) but alternative sensitivities (50-70-90%) in the detection of prior dengue infection. The impact of a screen-and-vaccinate strategy considered nine settings representing different levels of transmission intensity. Outcomes (dengue-related hospitalizations, severe dengue, and symptomatic dengue) were assessed according to the level of transmission setting. The cost-effectiveness of vaccination in 10 endemic countries was also assessed. RESULTS Although associated, in most cases, with a lower population impact than a 'no-screening' approach, a screen and vaccinate strategy is more effective in reducing the number of hospitalized and severe cases prevented per vaccination performed and generates positive health benefits for individuals screened and subsequently vaccinated. As a result, this intervention is cost-effective in all countries considered except for very low transmission settings. The overall population impact of a screen and vaccinate approach is also likely to be improved by the use of several rounds of screening (up to 48% reduction in dengue hospitalization over 10 years with 5 rounds). CONCLUSIONS WHO recommended option of a screen and vaccinate policy is likely to have a positive impact both at the individual and population level across a wide range of transmission settings and has the potential to be as, if not more, cost-effective than a no screening strategy.
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Affiliation(s)
| | - Nicolas Baurin
- Vaccination Value Modelling, Sanofi Pasteur, Lyon, France
| | - Donald S Shepard
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
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Abstract
Traditionally, statistical methods for futility analysis are developed based on a single study. To establish a drug's effectiveness, usually at least two adequate and well-controlled studies need to demonstrate convincing evidence on its own. Therefore, in a standard clinical development program in chronic diseases, two independent studies are generally conducted for drug registration. This paper proposes a statistical method to combine interim data from two independent and similar studies for interim futility analysis and shows that the conditional power approach based on combined interim data has better operating characteristics compared to the approach based on single-trial interim data, even with small to moderate heterogeneity on the treatment effects between the two studies.
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Affiliation(s)
- Qiqi Deng
- Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA
| | - Ying-Ying Zhang
- Department of Statistics and Actuarial Science, College of Mathematics and Statistics, Chongqing University, Chongqing, China
| | - Dooti Roy
- Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, USA Qiqi Deng and Ying-Ying Zhang are co-first authors
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13
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Yang SNY, Atkinson SC, Fraser JE, Wang C, Maher B, Roman N, Forwood JK, Wagstaff KM, Borg NA, Jans DA. Novel Flavivirus Antiviral That Targets the Host Nuclear Transport Importin α/β1 Heterodimer. Cells 2019; 8:cells8030281. [PMID: 30909636 PMCID: PMC6468590 DOI: 10.3390/cells8030281] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022] Open
Abstract
Dengue virus (DENV) threatens almost 70% of the world’s population, with no effective vaccine or therapeutic currently available. A key contributor to infection is nuclear localisation in the infected cell of DENV nonstructural protein 5 (NS5) through the action of the host importin (IMP) α/β1 proteins. Here, we used a range of microscopic, virological and biochemical/biophysical approaches to show for the first time that the small molecule GW5074 has anti-DENV action through its novel ability to inhibit NS5–IMPα/β1 interaction in vitro as well as NS5 nuclear localisation in infected cells. Strikingly, GW5074 not only inhibits IMPα binding to IMPβ1, but can dissociate preformed IMPα/β1 heterodimer, through targeting the IMPα armadillo (ARM) repeat domain to impact IMPα thermal stability and α-helicity, as shown using analytical ultracentrifugation, thermostability analysis and circular dichroism measurements. Importantly, GW5074 has strong antiviral activity at low µM concentrations against not only DENV-2, but also zika virus and West Nile virus. This work highlights DENV NS5 nuclear targeting as a viable target for anti-flaviviral therapeutics.
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Affiliation(s)
- Sundy N Y Yang
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Sarah C Atkinson
- Infection & Immunity Program, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Johanna E Fraser
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Chunxiao Wang
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Belinda Maher
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Noelia Roman
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia.
| | - Jade K Forwood
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia.
| | - Kylie M Wagstaff
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - Natalie A Borg
- Infection & Immunity Program, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
| | - David A Jans
- Nuclear Signaling Laboratory, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia.
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14
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Fauci A, Erbelding E, Whitehead S, Cassetti MC, Handley FG, Gupta R. Dengue vaccine clinical trials in India - An opportunity to inform the global response to a re-emerging disease challenge. Int J Infect Dis 2019; 84S:S4-S6. [PMID: 30880127 DOI: 10.1016/j.ijid.2019.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Anthony Fauci
- National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), USA.
| | - Emily Erbelding
- Division of Microbiology and Infectious Diseases, NIAID, NIH, USA.
| | | | - M Cristina Cassetti
- Virology Branch, Division of Microbiology and Infectious Diseases, NIAID, NIH, USA.
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15
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Perkins TA, Reiner RC, España G, ten Bosch QA, Verma A, Liebman KA, Paz-Soldan VA, Elder JP, Morrison AC, Stoddard ST, Kitron U, Vazquez-Prokopec GM, Scott TW, Smith DL. An agent-based model of dengue virus transmission shows how uncertainty about breakthrough infections influences vaccination impact projections. PLoS Comput Biol 2019; 15:e1006710. [PMID: 30893294 PMCID: PMC6443188 DOI: 10.1371/journal.pcbi.1006710] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/01/2019] [Accepted: 12/11/2018] [Indexed: 01/26/2023] Open
Abstract
Prophylactic vaccination is a powerful tool for reducing the burden of infectious diseases, due to a combination of direct protection of vaccinees and indirect protection of others via herd immunity. Computational models play an important role in devising strategies for vaccination by making projections of its impacts on public health. Such projections are subject to uncertainty about numerous factors, however. For example, many vaccine efficacy trials focus on measuring protection against disease rather than protection against infection, leaving the extent of breakthrough infections (i.e., disease ameliorated but infection unimpeded) among vaccinees unknown. Our goal in this study was to quantify the extent to which uncertainty about breakthrough infections results in uncertainty about vaccination impact, with a focus on vaccines for dengue. To realistically account for the many forms of heterogeneity in dengue virus (DENV) transmission, which could have implications for the dynamics of indirect protection, we used a stochastic, agent-based model for DENV transmission informed by more than a decade of empirical studies in the city of Iquitos, Peru. Following 20 years of routine vaccination of nine-year-old children at 80% coverage, projections of the proportion of disease episodes averted varied by a factor of 1.76 (95% CI: 1.54-2.06) across the range of uncertainty about breakthrough infections. This was equivalent to the range of vaccination impact projected across a range of uncertainty about vaccine efficacy of 0.268 (95% CI: 0.210-0.329). Until uncertainty about breakthrough infections can be addressed empirically, our results demonstrate the importance of accounting for it in models of vaccination impact.
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Affiliation(s)
- T. Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
| | - Robert C. Reiner
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, United States of America
| | - Guido España
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Quirine A. ten Bosch
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Amit Verma
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA
| | - Kelly A. Liebman
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - Valerie A. Paz-Soldan
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - John P. Elder
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Amy C. Morrison
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - Steven T. Stoddard
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Uriel Kitron
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
- Department of Environmental Sciences, Emory University, Atlanta, GA, United States of America
| | - Gonzalo M. Vazquez-Prokopec
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
- Department of Environmental Sciences, Emory University, Atlanta, GA, United States of America
| | - Thomas W. Scott
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - David L. Smith
- Fogarty International Center, National Institutes of Health, Bethesda, MD, United States of America
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
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16
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España G, Hogea C, Guignard A, ten Bosch QA, Morrison AC, Smith DL, Scott TW, Schmidt A, Perkins TA. Biased efficacy estimates in phase-III dengue vaccine trials due to heterogeneous exposure and differential detectability of primary infections across trial arms. PLoS One 2019; 14:e0210041. [PMID: 30682037 PMCID: PMC6347271 DOI: 10.1371/journal.pone.0210041] [Citation(s) in RCA: 443] [Impact Index Per Article: 88.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/14/2018] [Indexed: 01/20/2023] Open
Abstract
Vaccine efficacy (VE) estimates are crucial for assessing the suitability of dengue vaccine candidates for public health implementation, but efficacy trials are subject to a known bias to estimate VE toward the null if heterogeneous exposure is not accounted for in the analysis of trial data. In light of many well-characterized sources of heterogeneity in dengue virus (DENV) transmission, our goal was to estimate the potential magnitude of this bias in VE estimates for a hypothetical dengue vaccine. To ensure that we realistically modeled heterogeneous exposure, we simulated city-wide DENV transmission and vaccine trial protocols using an agent-based model calibrated with entomological and epidemiological data from long-term field studies in Iquitos, Peru. By simulating a vaccine with a true VE of 0.8 in 1,000 replicate trials each designed to attain 90% power, we found that conventional methods underestimated VE by as much as 21% due to heterogeneous exposure. Accounting for the number of exposures in the vaccine and placebo arms eliminated this bias completely, and the more realistic option of including a frailty term to model exposure as a random effect reduced this bias partially. We also discovered a distinct bias in VE estimates away from the null due to lower detectability of primary DENV infections among seronegative individuals in the vaccinated group. This difference in detectability resulted from our assumption that primary infections in vaccinees who are seronegative at baseline resemble secondary infections, which experience a shorter window of detectable viremia due to a quicker immune response. This resulted in an artefactual finding that VE estimates for the seronegative group were approximately 1% greater than for the seropositive group. Simulation models of vaccine trials that account for these factors can be used to anticipate the extent of bias in field trials and to aid in their interpretation.
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Affiliation(s)
- Guido España
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Cosmina Hogea
- GlaxoSmithKline, Rockville, MD, United States of America
| | | | - Quirine A. ten Bosch
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Amy C. Morrison
- United States Naval Medical Research Unit No. 6, Lima, Peru
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - David L. Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
| | - Thomas W. Scott
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | | | - T. Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
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17
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Sukhralia S, Verma M, Gopirajan S, Dhanaraj PS, Lal R, Mehla N, Kant CR. From dengue to Zika: the wide spread of mosquito-borne arboviruses. Eur J Clin Microbiol Infect Dis 2019; 38:3-14. [DOI: 10.1007/s10096-018-3375-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022]
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18
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Coudeville L, Baurin N, Olivera-Botello G. Assessment of benefits and risks associated with dengue vaccination at the individual and population levels: a dynamic modeling approach. Expert Rev Vaccines 2018; 17:753-763. [PMID: 30063839 DOI: 10.1080/14760584.2018.1503955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A case-cohort study, using a novel assay and data from three dengue vaccine efficacy trials, highlighted differences in vaccination outcomes according to baseline serostatus. Based on these results, we explored, with a model, the benefits and risks associated with vaccination. RESEARCH DESIGN AND METHODS Parameters of a previously developed transmission model were estimated with subject-level data from a case-cohort study. The model was used to assess vaccination outcomes for a range of transmission settings over 5-30 years, with or without indirect protection. MAIN OUTCOME MEASURES Symptomatic dengue cases, dengue hospitalizations, and severe dengue cases. RESULTS The model is consistent with previous results indicating a transitory period at increased risk for dengue-seronegative vaccine recipients (setting-dependent duration) and long-term benefits for dengue-seropositive recipients. At the population level, benefits to seropositive individuals over 10 years outweighed the risk to those seronegative in moderate to high transmission settings (≥50% seropositivity at age 9), especially in high transmission settings (no excess hospitalizations in dengue-seronegative for ≥80% seropositivity at age 9). Results were more favorable when longer time horizons or indirect protection were considered. CONCLUSIONS Results indicate a public health benefit associated with dengue vaccination especially in high-transmission settings, even with the initial excess risks to dengue-seronegative patients which diminish over time.
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Affiliation(s)
| | - Nicolas Baurin
- a Vaccination Value Modelling , Sanofi Pasteur , Lyon , France
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19
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Sridhar S, Luedtke A, Langevin E, Zhu M, Bonaparte M, Machabert T, Savarino S, Zambrano B, Moureau A, Khromava A, Moodie Z, Westling T, Mascareñas C, Frago C, Cortés M, Chansinghakul D, Noriega F, Bouckenooghe A, Chen J, Ng SP, Gilbert PB, Gurunathan S, DiazGranados CA. Effect of Dengue Serostatus on Dengue Vaccine Safety and Efficacy. N Engl J Med 2018; 379:327-340. [PMID: 29897841 DOI: 10.1056/nejmoa1800820] [Citation(s) in RCA: 480] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In efficacy trials of a tetravalent dengue vaccine (CYD-TDV), excess hospitalizations for dengue were observed among vaccine recipients 2 to 5 years of age. Precise risk estimates according to observed dengue serostatus could not be ascertained because of the limited numbers of samples collected at baseline. We developed a dengue anti-nonstructural protein 1 (NS1) IgG enzyme-linked immunosorbent assay and used samples from month 13 to infer serostatus for a post hoc analysis of safety and efficacy. METHODS In a case-cohort study, we reanalyzed data from three efficacy trials. For the principal analyses, we used baseline serostatus determined on the basis of measured (when baseline values were available) or imputed (when baseline values were missing) titers from a 50% plaque-reduction neutralization test (PRNT50), with imputation conducted with the use of covariates that included the month 13 anti-NS1 assay results. The risk of hospitalization for virologically confirmed dengue (VCD), of severe VCD, and of symptomatic VCD according to dengue serostatus was estimated by weighted Cox regression and targeted minimum loss-based estimation. RESULTS Among dengue-seronegative participants 2 to 16 years of age, the cumulative 5-year incidence of hospitalization for VCD was 3.06% among vaccine recipients and 1.87% among controls, with a hazard ratio (vaccine vs. control) through data cutoff of 1.75 (95% confidence interval [CI], 1.14 to 2.70). Among dengue-seronegative participants 9 to 16 years of age, the cumulative incidence of hospitalization for VCD was 1.57% among vaccine recipients and 1.09% among controls, with a hazard ratio of 1.41 (95% CI, 0.74 to 2.68). Similar trends toward a higher risk among seronegative vaccine recipients than among seronegative controls were also found for severe VCD. Among dengue-seropositive participants 2 to 16 years of age and those 9 to 16 years of age, the cumulative incidence of hospitalization for VCD was 0.75% and 0.38%, respectively, among vaccine recipients and 2.47% and 1.88% among controls, with hazard ratios of 0.32 (95% CI, 0.23 to 0.45) and 0.21 (95% CI, 0.14 to 0.31). The risk of severe VCD was also lower among seropositive vaccine recipients than among seropositive controls. CONCLUSIONS CYD-TDV protected against severe VCD and hospitalization for VCD for 5 years in persons who had exposure to dengue before vaccination, and there was evidence of a higher risk of these outcomes in vaccinated persons who had not been exposed to dengue. (Funded by Sanofi Pasteur; ClinicalTrials.gov numbers, NCT00842530 , NCT01983553 , NCT01373281 , and NCT01374516 .).
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Affiliation(s)
- Saranya Sridhar
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Alexander Luedtke
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Edith Langevin
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Ming Zhu
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Matthew Bonaparte
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Tifany Machabert
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Stephen Savarino
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Betzana Zambrano
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Annick Moureau
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Alena Khromava
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Zoe Moodie
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Ted Westling
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Cesar Mascareñas
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Carina Frago
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Margarita Cortés
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Danaya Chansinghakul
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Fernando Noriega
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Alain Bouckenooghe
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Josh Chen
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Su-Peing Ng
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Peter B Gilbert
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Sanjay Gurunathan
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
| | - Carlos A DiazGranados
- From Sanofi Pasteur, Marcy l'Etoile (S. Sridhar, E.L., A.M.), and Soladis, Lyon (T.M.) - both in France; Fred Hutchinson Cancer Research Center (A.L., Z.M., T.W., P.B.G.) and University of Washington, Seattle (T.W., P.B.G.) - both in Seattle; Sanofi Pasteur, Swiftwater, PA (M.Z., M.B., S. Savarino, F.N., J.C., S.G., C.A.D.); Sanofi Pasteur, Montevideo, Uruguay (B.Z.); Sanofi Pasteur, Toronto (A.K.); Sanofi Pasteur, Mexico City (C.M.); Sanofi Pasteur, Singapore, Singapore (C.F., A.B., S.-P.N.); Sanofi Pasteur, Bogota, Colombia (M.C.); and Sanofi Pasteur, Bangkok, Thailand (D.C.)
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Lecouturier V, Berry C, Saulnier A, Naville S, Manin C, Girerd-Chambaz Y, Crowe JE, Jackson N, Guy B. Characterization of recombinant yellow fever-dengue vaccine viruses with human monoclonal antibodies targeting key conformational epitopes. Vaccine 2018; 37:4601-4609. [PMID: 29706291 DOI: 10.1016/j.vaccine.2018.04.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/27/2018] [Accepted: 04/20/2018] [Indexed: 11/16/2022]
Abstract
The recombinant yellow fever-17D-dengue virus, live, attenuated, tetravalent dengue vaccine (CYD-TDV) is licensed in several dengue-endemic countries. Although the vaccine provides protection against dengue, the level of protection differs by serotype and warrants further investigation. We characterized the antigenic properties of each vaccine virus serotype using highly neutralizing human monoclonal antibodies (hmAbs) that bind quaternary structure-dependent epitopes. Specifically, we monitored the binding of dengue virus-1 (DENV-1; 1F4), DENV-2 (2D22) or DENV-3 (5J7) serotype-specific or DENV-1-4 cross-reactive (1C19) hmAbs to the four chimeric yellow fever-dengue vaccine viruses (CYD-1-4) included in phase III vaccine formulations using a range of biochemical and functional assays (dot blot, ELISA, surface plasmon resonance and plaque reduction neutralization assays). In addition, we used the "classic" live, attenuated DENV-2 vaccine serotype, immature CYD-2 viruses and DENV-2 virus-like particles as control antigens for anti-serotype-2 reactivity. The CYD vaccine serotypes were recognized by each hmAbs with the expected specificity, moreover, surface plasmon resonance indicated a high functional affinity interaction with the CYD serotypes. In addition, the hmAbs provided similar protection against CYD and wild-type dengue viruses in the in vitro neutralization assay. Overall, these findings demonstrate that the four CYD viruses used in clinical trials display key conformational and functional epitopes targeted by serotype-specific and/or cross-reactive neutralizing human antibodies. More specifically, we showed that CYD-2 displays serotype- specific epitopes present only on the mature virus. This indicates that the CYD-TDV has the ability to elicit antibody specificities which are similar to those induced by the wild type DENV. Future investigations will be needed to address the nature of CYD-TDV-induced responses after vaccine administration, and how these laboratory markers relate to vaccine efficacy and safety.
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Affiliation(s)
- Valerie Lecouturier
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Catherine Berry
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Aure Saulnier
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Sophie Naville
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Catherine Manin
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Yves Girerd-Chambaz
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - James E Crowe
- Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Nicholas Jackson
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
| | - Bruno Guy
- Research & Development, Sanofi Pasteur, Avenue Marcel Merieux, 69280 Marcy l'Etoile, France.
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Abstract
PURPOSE OF REVIEW Dengue, the most common arbovirus, is an increasingly significant cause of morbidity worldwide. After decades of research, an approved tetravalent dengue vaccine is finally available. Models constructed using recently available vaccine efficacy data allow for a data-driven discussion of the potential impact of dengue vaccine deployment on global control. RECENT FINDINGS Phase 3 efficacy trials demonstrated that the approved dengue vaccine, chimeric yellow fever-dengue-tetravalent dengue vaccine, has an efficacy of 60% against dengue illness of any severity. However, among dengue unexposed recipients, vaccination offers limited efficacy and may increase dengue severity. The WHO consequently recommends dengue vaccination for populations in which 70% of intended recipients are dengue seropositive. Models predict that routine childhood dengue vaccine may reduce dengue burden, but over time, population-level impact may be limited. Additional vaccine candidates in late-stage development may not suffer from the same limitations as chimeric yellow fever-dengue-tetravalent dengue vaccine. SUMMARY The efficacy and safety profile of the recently approved dengue vaccine is favorable only in previously dengue exposed recipients, which limits its potential for global control. Future work must evaluate the approved vaccine's long-term durability, efficacy of other late phase vaccine candidates, and potential for vector control efforts to work synergistically with vaccine deployment.
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Zeng W, Halasa-Rappel YA, Baurin N, Coudeville L, Shepard DS. Cost-effectiveness of dengue vaccination in ten endemic countries. Vaccine 2018; 36:413-20. [PMID: 29229427 DOI: 10.1016/j.vaccine.2017.11.064] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/14/2017] [Accepted: 11/19/2017] [Indexed: 11/21/2022]
Abstract
Following publication of results from two phase-3 clinical trials in 10 countries or territories, endemic countries began licensing the first dengue vaccine in 2015. Using a published mathematical model, we evaluated the cost-effectiveness of dengue vaccination in populations similar to those at the trial sites in those same Latin American and Asian countries. Our main scenarios (30-year horizon, 80% coverage) entailed 3-dose routine vaccinations costing US$20/dose beginning at age 9, potentially supplemented by catch-up programs of 4- or 8-year cohorts. We obtained illness costs per case, dengue mortality, vaccine wastage, and vaccine administration costs from the literature. We estimated that routine vaccination would reduce yearly direct and indirect illness cost per capita by 22% (from US$10.51 to US$8.17) in the Latin American countries and by 23% (from US$5.78 to US$4.44) in the Asian countries. Using a health system perspective, the incremental cost-effectiveness ratio (ICER) averaged US$4,216/disability-adjusted life year (DALY) averted in the five Latin American countries (range: US$666/DALY in Puerto Rico to US$5,865/DALY in Mexico). In the five Asian countries, the ICER averaged US$3,751/DALY (range: US$1,935/DALY in Malaysia to US$5,101/DALY in the Philippines). From a health system perspective, the vaccine proved to be highly cost effective (ICER under one times the per capita GDP) in seven countries and cost effective (ICER 1-3 times the per capita GDP) in the remaining three countries. From a societal perspective, routine vaccination proved cost-saving in three countries. Including catch-up campaigns gave similar ICERs. Thus, this vaccine could have a favorable economic value in sites similar to those in the trials.
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Fernandez EA. Moving to a Dengue Preventive Treatment Through New Vaccines. Curr Treat Options Infect Dis 2017. [DOI: 10.1007/s40506-017-0132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tian H, Sun Z, Faria NR, Yang J, Cazelles B, Huang S, Xu B, Yang Q, Pybus OG, Xu B. Increasing airline travel may facilitate co-circulation of multiple dengue virus serotypes in Asia. PLoS Negl Trop Dis 2017; 11:e0005694. [PMID: 28771468 PMCID: PMC5542384 DOI: 10.1371/journal.pntd.0005694] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/08/2017] [Indexed: 12/26/2022] Open
Abstract
The incidence of dengue has grown dramatically in recent decades worldwide, especially in Southeast Asia and the Americas with substantial transmission in 2014-2015. Yet the mechanisms underlying the spatio-temporal circulation of dengue virus (DENV) serotypes at large geographical scales remain elusive. Here we investigate the co-circulation in Asia of DENV serotypes 1-3 from 1956 to 2015, using a statistical framework that jointly estimates migration history and quantifies potential predictors of viral spatial diffusion, including socio-economic, air transportation and maritime mobility data. We find that the spread of DENV-1, -2 and -3 lineages in Asia is significantly associated with air traffic. Our analyses suggest the network centrality of air traffic hubs such as Thailand and India contribute to seeding dengue epidemics, whilst China, Cambodia, Indonesia, and Singapore may establish viral diffusion links with multiple countries in Asia. Phylogeographic reconstructions help to explain how growing air transportation networks could influence the dynamics of DENV circulation.
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Affiliation(s)
- Huaiyu Tian
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Zhe Sun
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, School of Environment, Tsinghua University, Beijing, China
| | | | - Jing Yang
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Bernard Cazelles
- Ecologie & Evolution, UMR 7625, UPMC-ENS, Paris, France
- UMMISCO UMI 209 IRD - UPMC, Bondy, France
| | - Shanqian Huang
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Bo Xu
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, School of Environment, Tsinghua University, Beijing, China
| | - Qiqi Yang
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Oliver G. Pybus
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- * E-mail: (OP); (BiX)
| | - Bing Xu
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, School of Environment, Tsinghua University, Beijing, China
- * E-mail: (OP); (BiX)
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Guy B, Noriega F, Ochiai RL, L’azou M, Delore V, Skipetrova A, Verdier F, Coudeville L, Savarino S, Jackson N. A recombinant live attenuated tetravalent vaccine for the prevention of dengue. Expert Rev Vaccines 2017; 16:1-13. [DOI: 10.1080/14760584.2017.1335201] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Bruno Guy
- Research & Development, Sanofi Pasteur, Lyon, France
| | | | | | - Maïna L’azou
- Global Epidemiology, Sanofi Pasteur, Lyon, France
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Abstract
The flaviviruses are small single-stranded RNA viruses that are typically transmitted by mosquito or tick vectors. These "arboviruses" are found around the world and account for a significant number of cases of human disease. The flaviviruses cause diseases ranging from mild or sub-clinical infections to lethal hemorrhagic fever or encephalitis. In many cases, survivors of neurologic flavivirus infections suffer long-term debilitating sequelae. Much like the emergence of West Nile virus in the United States in 1999, the recent emergence of Zika virus in the Americas has significantly increased the awareness of mosquito-borne viruses. The diseases caused by several flaviviruses have been recognized for decades, if not centuries. However, there is still a lot that is unknown about the flaviviruses as the recent experience with Zika virus has taught us. The objective of this review is to provide a general overview and some historical perspective on several flaviviruses that cause significant human disease. In addition, available medical countermeasures and significant gaps in our understanding of flavivirus biology are also discussed.
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Affiliation(s)
- Michael R Holbrook
- NIAID Integrated Research Facility, 8200 Research Plaza, Ft. Detrick, Frederick, MD 21702, USA.
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Abstract
Background The incidence of dengue fever (DF) is steadily increasing in Mexico, burdening health systems with consequent morbidities and mortalities. On December 9th, 2015, Mexico became the first country for which the dengue vaccine was approved for use. In anticipation of a vaccine rollout, analysis of the cost-effectiveness of the dengue vaccination program that quantifies the dynamics of disease transmission is essential. Methods We developed a dynamic transmission model of dengue in Yucatán, Mexico and its proposed vaccination program to incorporate herd immunity into our analysis of cost-effectiveness analysis. Our model also incorporates important characteristics of dengue epidemiology, such as clinical cross-immunity and susceptibility enhancement upon secondary infection. Using our model, we evaluated the cost-effectiveness and economic impact of an imperfect dengue vaccine in Yucatán, Mexico. Conclusions Our study indicates that a dengue vaccination program would prevent 90% of cases of symptomatic DF incidence as well as 90% of dengue hemorrhagic fever (DHF) incidence and dengue-related deaths annually. We conclude that a dengue vaccine program in Yucatán, Mexico would be very cost-effective as long as the vaccination cost per individual is less than $140 and $214 from health care and societal perspectives, respectively. Furthermore, at an exemplary vaccination cost of $250 USD per individual on average, dengue vaccination is likely to be cost-effective 43% and 88% of the time from health care and societal perspectives, respectively.
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Affiliation(s)
- Eunha Shim
- Department of Mathematics, Soongsil University, Seoul, Republic of Korea
- * E-mail:
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28
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Nikin-Beers R, Ciupe SM. Modelling original antigenic sin in dengue viral infection. Mathematical Medicine and Biology: A Journal of the IMA 2017; 35:257-272. [DOI: 10.1093/imammb/dqx002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/23/2017] [Indexed: 01/04/2023]
Affiliation(s)
| | - Stanca M Ciupe
- Department of Mathematics, Virginia Tech, Blacksburg, VA, USA
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Affiliation(s)
- Maíra Aguiar
- Department of Mathematics, Centro de Matemática e Aplicações Fundamentais da Universidade de Lisboa, Lisboa, Portugal
| | - Scott B. Halstead
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Nico Stollenwerk
- Department of Mathematics, Centro de Matemática e Aplicações Fundamentais da Universidade de Lisboa, Lisboa, Portugal
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Aguiar M, Stollenwerk N, Halstead SB. The Impact of the Newly Licensed Dengue Vaccine in Endemic Countries. PLoS Negl Trop Dis 2016; 10:e0005179. [PMID: 28002420 DOI: 10.1371/journal.pntd.0005179] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/09/2016] [Indexed: 11/22/2022] Open
Abstract
Background With approximately 3 billion people at risk of acquiring the infection, dengue fever is now considered the most important mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year, of which 96 million manifest symptoms with any level of disease severity. Treatment of uncomplicated dengue cases is only supportive and severe dengue cases require hospital intensive care. A vaccine now licensed in several countries and developed by Sanofi Pasteur (CYD-TDV, named Dengvaxia), was able to protect, in the first 25 months of the two Phase III, 66% of a subset of 9–16 year old participants. However, a significantly lower efficacy (including negative vaccine efficacy) was noted for children younger than 9 years of age. Methodology/Principal Findings Analysis of year 3 results of phase III trials of Dengvaxia suggest high rates of protection of vaccinated partial dengue immunes but high rates of hospitalizations during breakthrough dengue infections of persons who were vaccinated when seronegative, with vaccine appearing to induce enhancing antibodies (ADE). An age structured model was developed based on Sanofi’s recommendation to vaccinate persons age 945 years in dengue endemic countries. The model was used to explore the clinical burden of two vaccination strategies: 1) Vaccinate 4 or 20% of individuals, ages 9–45 years, seropositives and seronegatives, and 2) vaccinate 4 or 20% of individuals, ages 9–45 years, who are dengue immune only. Conclusions/Significance Our results show that vaccinating dengue monotypic immune individuals prevents dengue hospitalizations, but at the same time dengue infections of vaccine-sensitized persons increases hospitalizations. When the vaccine is given only to partial immune individuals, after immunological screening of the population, disease burden decreases considerably. Caused by four antigenically related but distinct serotypes a tetravalent vaccine is needed to protect against the huge burden of dengue disease. Dengvaxia is a vaccine candidate now licensed in several countries for individuals 9–45 years of age living in endemic countries with at least 50% (preferably 70%) of seroprevalence. Modelers from Sanofi Pasteur have predicted that this vaccine has the potential to reduce by about 50% the disease burden within 5 years when 20% of an endemic country population is vaccinated, thus achieving a World Health Organization dengue prevention goal. In this paper, mathematical modeling is used to investigate the impact of the newly licensed dengue vaccine using different scenarios. Our results show that to achieve significant reduction in disease burden, the vaccination program is most effective if it includes only individuals that have been already exposed to at least one dengue virus. Immunological screening of the population prior to vaccination is advised and vaccination strategies must be planned based on epidemiological disease dynamics for each specific endemic region.
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