Mathematical Analysis of the Transmission Dynamics of Anogenital Warts-causing HPV Types between Male and Female in the Republic of Korea

Abstract

Background. There has been a lot of research to identify an epidemiologic characteristics on Human Papillomavirus (HPV). But there is no study to research the prediction for HPV epidemics and the effect of vaccination with reflecting current status of the disease in the Republic of Korea. Therefore, it is important to investigate the dynamics of HPV infection transmission in the Republic of Korea.

Purpose. The purpose of this thesis is to explore the epidemiological significant factors contributing to the spread of HPV in the Republic of Korea using a mathematical model. Furthermore, the effects of vaccination program are investigated to prevent HPV infection associated with anogenital warts.

Methods. The prevalence data of anogenital warts retrieved from the National Health Insurance Service from 2002 to 2015 is analyzed. It is including the gender, birth year, residence, the diagnosed day. A two-sex, deterministic ordinary differential equations model is constructed and analyzed to investigate the impact of prophylactic vaccination against HPV on HPV 6 and/or 11 prevalence. Sensitivity analysis is performed to increase the model’s predictive capability and to enhance its reliability.

Results. The sex-specific heterosexual transmission rate of HPV infection is estimated by fitting the model to the anogenital warts prevalence data. The transmission rate of female-to-male is greater than male-to female, resulting in higher incident HPV infection among men. The estimated cumulative number of vaccinated female is 2.3% of the female population aged 19-59 years, and the estimated number of anogenital wart reduction are about 13.8% and 9.5% of the cumulative number of female and male anogenital warts from 2008 to 2015 due to vaccination. The vaccine strategies affect the prevalence of HPV that would be expected if a vaccine program is implemented. A female vaccine is most effective in reducing the total amount of anogenital warts.

Conclusion. A mathematical model for HPV transmission is developed using various methodologies to gain better understanding of HPV dynamics in the Republic of Korea. The best possible vaccination strategy of HPV and HPV epidemic response plans have been proposed by analyzing vaccination strategies in the HPV model. Vaccination strategies are investigated by setting up a variety of scenarios.