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Title: Hope-Simpsons Progressive Immunity Hypothesis as a Possible Explanation for Herpes Zoster Incidence Data
Authors: Guzzetta, Giorgio
Poletti, Piero
DEL FAVA, Emanuele 
Ajelli, Marco
Tomba, Gian Paolo Scalia
Merler, Stefano
Manfredi, Piero
Issue Date: 2013
Source: AMERICAN JOURNAL OF EPIDEMIOLOGY, 177 (10), p. 1134-1142
Abstract: Varicella-zoster virus (VZV) is the causative agent of both varicella (chickenpox) and herpes zoster (HZ) (shingles). After varicella infection, the virus remains dormant in the hosts dorsal ganglia and can reactivate due to waning cell-mediated immunity, causing HZ. Exposure of varicella-immune persons to VZV may boost the hosts immune response, resulting in a protective effect against HZ. In this study, we used mathematical models of VZV transmission and HZ development to test the biological hypothesis of progressive immunity, originally proposed by Hope-Simpson (Proc R Soc Med. 1965;58:920), that cell-mediated protection against HZ increases after each episode of exposure to VZV. Predictions from a model incorporating such a hypothesis were compared with those of other concurrent models proposed for explaining HZ epidemiology. The progressive immunity model fits significantly better the age profile of HZ incidence for Finland (years 20002006), Italy (20032005), Spain (19972004), and the United Kingdom (19911992), suggesting that this mechanism may be critical in shaping HZ patterns. The model thus validated is an alternative to VZV models currently used to evaluate the impact of mass immunization programs for varicella and therefore extends the range of tools available to assist policy-makers with the present decision paralysis on the introduction of vaccination.
Notes: Guzzetta, G (reprint author), Univ Pisa, Dept Math & Stat, Fac Econ, Pisa, Italy. Bruno Kessler Fdn, Ctr Informat Technol, Trento, Italy. Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat I Biost, Diepenbeek, Belgium. Univ Roma Tor Vergata, Fac Sci, Dept Math, Rome, Italy.
Keywords: chickenpox; herpes zoster; immunity, cellular; mathematical model; vaccination;chickenpox; herpes zoster; immunity; cellular; mathematical model; vaccination
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ISSN: 0002-9262
e-ISSN: 1476-6256
DOI: 10.1093/aje/kws370
ISI #: 000318801200012
Rights: © The Author 2013. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:
Category: A1
Type: Journal Contribution
Validations: ecoom 2014
Appears in Collections:Research publications

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