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We work on hepatitis B virus (HBV), a substantial global health challenge with an estimated burden of 290 million infected individuals, leading to 800,000 deaths per year. The infection has been neglected in comparison to other chronic infections of this magnitude, but increased interest and investment are now underpinned by Sustainable Development Goals that set out targets for elimination of HBV as a public health threat by the year 2030.

We have diverse multi-disciplinary projects, underpinned by strong clinical links, with the united aim of improving an understanding of how the interaction between host and virus can lead to different outcomes. We have a particular focus on populations in sub-Saharan Africa, where HBV infection is endemic and populations are particularly vulnerable to liver disease associated with chronic infection.

Examples of some of our studies include:

1. We are recruiting adults with chronic HBV infection in Oxford, and through collaborations with the University of Stellenbosch and the University of the Free State in South Africa. By amassing a large cohort, we hope to be able to develop better insights into how the genetics of the host, and the genetics of the virus, interact to determine different outcomes. Through these insights, we will be able to derive information that is useful in guiding the monitoring and treatment of patients, as well as potentially informing new cure strategies.

2. We are undertaking lab work to develop better approaches to generating deep, full-length sequences of HBV. This will allow us to form a better picture of the diversity within and between hosts, and the impact of changes in the viral genetic sequence on outcomes of infection. We are using a well established approach, Illumina, as well as developing protocols using the newer Oxford Nanopore Technologies.

3. We are interested in defining and tracking drug resistance in HBV, to understand how widespread this problem is in different regions, and how this impacts on clinical outcomes, with the ultimate aim of providing better patient-stratified therapy.

4. We are working with collaborators in the Zoology Department to develop and refine mathematical models to investigate the dynamics of HBV in different populations, and to investigate the impact of interventions over time.

5. We have developed a collaboration with the MRC General Population Cohort in Uganda, through which we are advancing studies of liver disease, including a focus on adults with chronic HBV infection. Through this connection, we are also working on a project to investigate the nature and impact of stigma associated with HBV infection.

6. Our team works together with the NIHR Health Informatics Collaborative, using clinical data that are routinely collected for patients with hepatitis infections, and collating these in anonymised forms to use for research. We have focused on using these data to develop a better picture of patients who clear HBV infection, with future aspirations to improve the use of biomarkers for prognosis and treatment.

More information about our work can be found here.

 

Our team