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首页> 外文期刊>Mathematical Biosciences: An International Journal >Differential characteristics of primary infection and re-infection can cause backward bifurcation in HCV transmission dynamics
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Differential characteristics of primary infection and re-infection can cause backward bifurcation in HCV transmission dynamics

机译：原发感染和再感染的差异性特征可导致HCV传播动力学的反向分叉

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摘要

Backward bifurcation, a phenomenon typically characterized by the co-existence of multiple stable equilibria when the associated reproduction number of the model is less than unity, has been observed in numerous disease transmission models. This study establishes, for the first time, the presence of this phenomenon in the transmission dynamics of hepatitis C virus (HCV) within an IDU population. It is shown that the phenomenon does not exist under four scenarios, namely (i) in the absence of re-infection, (ii) in the absence of differential characteristics of HCV infection (with respect to infectivity, progression, treatment and recovery) between re-infected individuals and primary-infected individuals, (iii) when re-infected and treated individuals do not transmit HCV infection and (iv) when the average infectivity-adjusted duration of re-infection is less than that of primary infection. This study identifies, using sensitivity analysis, five parameters of the model that have the most influence on the disease transmission dynamics, namely: effective contact rate, progression rate from acute to chronic infection, recovery rate from acute infection, natural death rate and the relative infectiousness of chronically-infected individuals. Numerical simulations of the model show that the reinfection of recovered individuals has marginal effect on the HCV burden (as measured in terms of the cumulative incidence and the prevalence of the disease) in the IDU community. Furthermore, treatment of infected IDUs, even for small rate (such as 4%), offers significant impact on curtailing HCV spread in the community. (C) 2015 Elsevier Inc. All rights reserved.
机译：向后分叉是一种在许多疾病传播模型中都观察到的现象，当模型的相关复制数小于1时，通常以多个稳定平衡的共存为特征。这项研究首次在IDU人群中的丙型肝炎病毒（HCV）传播动力学中发现了这种现象。结果表明，在以下四种情况下不存在该现象：（i）没有再次感染，（ii）在两次感染之间没有HCV感染的差异特征（关于感染性，进展，治疗和恢复）重新感染的个体和原发感染的个体，（iii）当再次感染和治疗的个体不传播HCV感染时，和（iv）当平均感染性调整后的重新感染持续时间少于原发感染时。本研究使用敏感性分析确定了对疾病传播动力学影响最大的五个模型参数，即：有效接触率，从急性到慢性感染的进展率，从急性感染的恢复率，自然死亡率和相对慢性感染者的传染性。该模型的数值模拟表明，在IDU社区中，恢复个体的再感染对HCV负担（以疾病的累积发生率和患病率衡量）具有边际影响。此外，即使是很小的感染率（例如4％），感染IDU的治疗也对减少HCV在社区中的传播具有重大影响。 （C）2015 Elsevier Inc.保留所有权利。

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