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Comparative Study
. 2020 Aug 10;15(8):e0237525.
doi: 10.1371/journal.pone.0237525. eCollection 2020.

Modelling hepatitis B virus infection and impact of timely birth dose vaccine: A comparison of two simulation models

Margaret J de Villiers  1 , Ivane Gamkrelidze  2 , Timothy B Hallett  1 , Shevanthi Nayagam  1   3 , Homie Razavi  2 , Devin Razavi-Shearer  2
Affiliations
Comparative Study

Modelling hepatitis B virus infection and impact of timely birth dose vaccine: A comparison of two simulation models

Margaret J de Villiers et al. PLoS One. .

Abstract

Hepatitis B is a global epidemic that requires carefully orchestrated vaccination initiatives in geographical regions of medium to high endemicity to reach the World Health Organization's elimination targets by 2030. This study compares two widely-used deterministic hepatitis B models-the Imperial HBV model and the CDA Foundation's PRoGReSs-based on their predicted outcomes in four countries. The impact of scaling up of the timely birth dose of the hepatitis B vaccine is also investigated. The two models predicted largely similar outcomes for the impact of vaccination programmes on the projected numbers of new cases and deaths under high levels of the infant hepatitis B vaccine series. However, scenarios for the scaling up of the infant hepatitis B vaccine series had a larger impact in the PRoGReSs model than in the Imperial model due to the infant vaccine series directly leading to the reduction of perinatal transmission in the PRoGReSs model, but not in the Imperial model. Meanwhile, scaling up of the timely birth dose vaccine had a greater impact on the outcomes of the Imperial hepatitis B model than in the PRoGReSs model due to the greater protection that the birth dose vaccine confers to infants in the Imperial model compared to the PRoGReSs model. These differences underlie the differences in projections made by the models under some circumstances. Both sets of assumptions are consistent with available data and reveal a structural uncertainty that was not apparent in either model in isolation. Those relying on projections from models should consider outputs from both models and this analysis provides further evidence of the benefits of systematic model comparison for enhancing modelling analyses.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Historical coverage with timely birth dose and the infant HBV vaccine series.
Coverage data were obtained from the Polaris Observatory.
Fig 2
Fig 2. Incident cases of chronic HBV infection per year between 2015 and 2099.
Fig 3
Fig 3. HBV-related deaths per year between 2015 and 2099.
Fig 4
Fig 4. Incidence rates of chronic HBV infection in scenario I in four age groups.
Fig 5
Fig 5. Percentage incident chronic HBV cases in scenario I due to perinatal and horizontal infections.
Fig 6
Fig 6. The risk of acute HBV developing into chronic HBV in the two models.
Fig 7
Fig 7. Perinatal HBV infections in scenario I and CHB infections averted between scenarios II and III in India and Pakistan in the Imperial model, the PRoGReSs model and the modified Imperial model.
CHB: chronic hepatitis B; HBV: hepatitis B virus.
See this image and copyright information in PMC

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