Bimodal distribution and set point HBV DNA viral loads in chronic infection: retrospective analysis of cohorts from the UK and South Africa.
Louise O DownsSabeehah VawdaPhillip Armand BesterKatrina A LythgoeTingyan WangAnna L McNaughtonDavid A SmithTongai MapongaOliver FreemanKinga A VárnaiJim DaviesKerrie WoodsChristophe FraserEleanor BarnesDominique GoedhalsPhilippa Clare MatthewsPublished in: Wellcome open research (2020)
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.
Keyphrases
- hepatitis b virus
- cross sectional
- hepatitis c virus
- south africa
- sars cov
- liver failure
- hiv positive
- public health
- human immunodeficiency virus
- peripheral blood
- electronic health record
- antiretroviral therapy
- big data
- poor prognosis
- hiv infected
- physical activity
- men who have sex with men
- single cell
- single molecule
- combination therapy
- machine learning
- hiv testing
- deep learning
- long non coding rna
- artificial intelligence
- circulating tumor
- drug induced