July 28, 2018, by Emma Rayner

University of Nottingham researchers working to eliminate viral hepatitis

In this blog, Dr Alex Tarr from the School of Life Sciences, explains why this year’s World Hepatitis Day (Saturday July 28 2018) is an important opportunity to raise awareness about the global health and social burden of viral hepatitis.

More than 300 million people worldwide are infected with viruses that result in liver damage, resulting in more than a million deaths each year. Elimination of these infections as a public health concern remains a great challenge for scientists, clinicians and policy makers.

The two viruses that are responsible for the majority of infections are hepatitis B virus (HBV) and hepatitis C virus (HCV). Both viruses can cause life-long infection, with persistent infection resulting in liver damage, cirrhosis and liver cancer. While most infections occur in low and middle-income countries, in the UK approximately 250,000 people are infected with HBV or HCV. Infection with HCV is the most common reason for patients requiring liver transplants, placing a financial burden on the NHS.

Researchers in the School of Life Sciences and School of Medicine at the University of Nottingham are undertaking pioneering research to discover new ways to tackle hepatitis B and hepatitis C infections. The teams, led by Professor William Irving, Professor Jonathan Ball, Dr Brian Thomson and Dr Alexander Tarr are investigating new ways to diagnose and treat HBV and HCV, as well as developing new strategies to improve vaccination for both viruses.

Preventing hepatitis B virus infections in Indonesia

Vaccines for HBV have been available for the past 30 years. However, despite the potential for preventing virus infection by immunisation, some countries have high prevalence of infection, particularly in the new-born. In Indonesia approximately 10% of the population is infected with HBV. Many children are born to HBV-positive mothers and remain infected for life. In collaboration with researchers working in maternity clinics in Indonesia, our research is utilising state-of-the-art DNA sequencing technologies to identify types of HBV that are resistant to the vaccine. This research will allow identification of ways in which to improve on current vaccines and break the cycle of infection from mothers to their babies.

Improving therapy for hepatitis C infection

The HCV research field has recently been revolutionised by the introduction of safe, effective oral drugs that can eliminate infection with a 12-week course of therapy. However, working in collaboration with researchers at the MRC-University of Glasgow Centre for Virus Research, we have identified types of HCV that are resistant to these new drugs. These viruses are often found in people living in the countries of sub-Saharan Africa, where access to new therapies may be limited. Our current research investigates the impact of these drug-resistance mutations on disease progression and how we can target therapy more effectively, limiting the potential for emergence of drug-resistant viruses.

Developing vaccines for hepatitis C virus

Despite the introduction of excellent therapies for HCV, a safe, effective vaccine remains an urgent priority to aid elimination of HCV infection world-wide. We have investigated in detail the potential for protective antibodies to inhibit HCV infection, identifying regions of the virus particle that are excellent targets for vaccine design. Our most recent research in this area has been developing novel vaccine candidates, which are now in pre-clinical assessment.

Together, the research being performed at the University of Nottingham in the field of viral hepatitis is addressing key questions around the clinical management and global eradication of these important diseases.

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