Epidemics

Epidemiology

The HIV/AIDS epidemic constitutes a major challenge to mankind. Up to now, HIV cannot be cleared by antivirals from people infected with the virus. This necessitates life-long therapy to prevent viral rebound and symptoms of immunodeficiency. Such therapy is prone to drug resistance and constitutes a major financial burden. An effective way to stop the epidemic is to disrupt its spread. For many viral infections this can be achieved through large vaccination programmes. For HIV/AIDS, however, the development of a safe, broadly protective and accessible vaccine remains elusive. Awareness programmes have sucessfully reduced HIV incidence, however, these approaches do not suffice to stop the spread-, or eliminate HIV.

Our major focuss is on antiviral strategies to prevent HIV; a novel approach that can effectively stop HIV transmission. Together with the Tropeninstitut at Charite Berlin and clinical pharmacologists, we have constructed a mathematical modeling framework to assess antiviral strategies to prevent Mother-to-Child transmission of HIV in resource-constrained countries (paper on MTCT). This framework allowed us to elucidate the mechanims of HIV prevention during the birth process and to perform cost-effectiveness calculations, which can have important implications for disease control in countries hit hardest by the epidemic. Moreover, we are analyzing the impact of pre-exposure prophylaxis (PrEP) in uninfected individuals at risk (paper on PrEP), revealing pharmacological limitations of current strategies.

Together with the Robert Koch Institute, we are assessing transmission networks to optimize the delivery of epidemiologic control strategies.