Publication highlights

This research explores the use of a biomarker of hepatitis B infection, 'core related antigen', to help identify people at highest risk of complications, who may benefit from treatment. Researchers at the Crick have investigated the role of this marker in UK and South African populations, exploring differences in its performance between settings. This is of importance given new World Health Organization guidelines which recommend offering treatment to many more people living with HBV.

Hepatitis Delta Virus (HDV) is a serious infection that worsens liver disease in people who already are living with Hepatitis B. It is highly endemic in the World Health Organisation (WHO) African region, where unique forms of the virus exist and the need for treatment is especially urgent. Novel drugs to cure this disease are being trialed. The researchers looked at all HDV clinical trials registered globally. Out of 47 trials, most were based in WHO Europe (about 7 out of 10), with some in the Americas and Western Pacific regions. Shockingly, none of the trials took place in the WHO African region. They believe clinical trials in WHO Africa are essential to make sure that new drugs work for people across different populations and virus types, and to ensure fair access when these treatments become available.

Hepatitis B core related antigen (HBcrAg) is a biomarker of replication in hepatitis B virus (HBV) infection. There are very few data representing the use of HBcrAg in African populations, and measuring it using a Point of Care Test has only been done in one other African setting. This study helps determine a use case and explores the extent to which a positive HBcrAg correlates with existing biomarkers for people living with HBV in Kenya.

Chronic hepatitis B (CHB) affects 254 million people globally, contributing significantly to cirrhosis and liver cancer. Work led by Philippa Matthews through the UK NIHR 'Health Informatics Collaborative' for viral hepatitis looked at the dynamics of hepatitis B virus (HBV) viral load and its relationship with liver disease in patients with CHB who were on long-term nucleos/tide analogue (NA) treatment. Virologic responses to NA therapy showed significant variability, and in 20% of individuals on treatment, HBV was not suppressed, or declined slowly on treatment over more than a year. In some cases, this was associated with a twofold increased risk of liver disease progression. These insights are relevant to supporting the management of CHB patients, helping the development of personalised treatment approaches.