Browsing by Author "Smith, David A."

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    Bimodal distribution and set point HBV DNA viral loads in chronic infection : retrospective analysis of cohorts from the UK and South Africa
    (Wellcome Open Research, 2020-10-14) Downs, Louise O.; Vawda, Sabeehah; Bester, Phillip Armand; Lythgoe, Katrina A.; Wang, Tingyan; McNaughton, Anna L.; Smith, David A.; Maponga, Tongai; Freeman, Oliver; Várnai, Kinga A.; Davies, Jim; Woods, Kerrie; Fraser, Christophe; Barnes, Eleanor; Goedhals, Dominique; Matthews, Philippa C.
    ENGLISH ABSTRACT: Hepatitis B virus (HBV) viral load (VL) is used as a biomarker to assess risk of disease progression, and to determine eligibility for treatment. While there is a well recognised association between VL and the expression of the viral e-antigen protein, the distributions of VL at a population level are not well described. We here present cross-sectional, observational HBV VL data from two large population cohorts in the UK and in South Africa, demonstrating a consistent bimodal distribution. The right skewed distribution and low median viral loads are different from the left-skew and higher viraemia in seen in HIV and hepatitis C virus (HCV) cohorts in the same settings. Using longitudinal data, we present evidence for a stable 'set-point' VL in peripheral blood during chronic HBV infection. These results are important to underpin improved understanding of HBV biology, to inform approaches to viral sequencing, and to plan public health interventions.