Autonomous Targeting of Infectious Superspreaders Using Engineered Transmissible Therapies

Metzger, Vincent T.; Lloyd-Smith, James O.; Weinberger, Leor S.

As with all models, our analysis is a relatively simple representation of a complex system and necessarily makes certain assumptions. Importantly, the TIP's robustness and efficacy stems from the unique and defining ability of TIPs to transmit between hosts and, as such, the general results presented for the TIP are qualitatively robust to changes in parameter values or in basic model assumptions about transmission biology (see Text S1). TIP efficacy also appears qualitatively robust to decreases in transmis-sion efficiency as a result of widespread ART coverage (Figure 3c d) or re-parameterization of transmission functions (see Text S1). Nevertheless, our analysis is intended as a first step towards motivating research into transmissible therapies, rather than a proof of efficacy. The molecular, epidemiological, and ethical bases of using TIP intervention against pathogens will require extensive study, but our results show that TIPs may offer a unique strategy for targeting both high-risk and hard-to-reach populations, overcoming behavioral barriers, and circumventing mutational escape to achieve indefinite disease suppression of HIV, and possibly other pathogens, in resource-limited settings.