Bimodal distribution and set point HBV DNA viral loads in chronic infection: retrospective analysis of cohorts from the UK and South Africa

Louise O Downs, Sabeehah Vawda, Phillip Armand Bester, Katrina A Lythgoe, Tingyan Wang, Anna L McNaughton, David A Smith, Tongai Maponga, Oliver Freeman, Kinga A Várnai, Jim Davies, Kerrie Woods, Christophe Fraser, Eleanor Barnes, Dominique Goedhals*, Philippa C Matthews

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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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.

Original languageEnglish
Number of pages13
JournalWellcome Open Research
Volume5
Issue number113
DOIs
Publication statusPublished - 14 Oct 2020

Keywords

  • HBV
  • HIV
  • viral load
  • set point
  • distribution

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