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Assessing liver pathologies associated with Hepatitis B and Schistosoma mansoni coinfections

2024/4

external supervisor

Professor Philippa Mathews, Nuffield Department of Medicine

background

Hepatitis B (HBV) and Schistosoma mansoni are both chronic infections—the former caused by a virus and the latter by a parasitic blood fluke—that affect the liver and are highly prevalent in sub-Saharan Africa. Coinfections exacerbate liver pathologies including the severity of liver fibrosis that may ultimately lead to liver failure. In Northwestern Uganda, the prevalence of Schistosoma mansoni is over 50% in children and adults, and HBV is estimated at 12-15% in adults. Both HBV infection and schistosomiasis have been separately associated with low socioeconomic status. Despite their shared biological and social pathways, little is known about the co-distribution of these infections and their shared influence on liver pathologies including hepatomegaly, fibrosis, cirrhosis, and hepatocellular cancers.

RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING

This project will use data from an ongoing cohort study (SchistoTrack) in rural villages in Uganda where S. mansoni is endemic. Ethical approvals have been obtained. The baseline and two annual follow-ups will be completed prior to the start of this DPhil project. Three more years of follow-up will occur during the timeframe of this DPhil. A random sample of approximately 2400 households from 52 villages (~4000 individuals aged 5+ years) will be available for analysis. Rapid diagnostics for HBV and schistosomiasis will be available with also microscopy data for schistosome infections. Detailed information will be available on demographics, socioeconomic status, and water, sanitation, and hygiene access/behaviours, ecology, household location, health care access, and case management within primary health care centres. Data from point-of-care ultrasounds is available to evaluate liver pathologies, as well as immune profiles and fibrotic scores.

Aims:

  1. Establish the epidemiology (key risk factors) for HBV infections in the study population, including identifying relevant clinical phenotypes associated to HBV infections.
  2. Investigate the interplay between schistosome infection and hepatitis B susceptibility and chronicity.
  3. Identify schistosome and HBV interactions and their influence on liver pathologies.

The student will gain skills in literature review, primary data collection, clinical epidemiological data analysis, statistical programming, data cleaning, and research presentation.

FIELD WORK, SECONDMENTS, INDUSTRY PLACEMENTS AND TRAINING

This DPhil project requires one to two months of fieldwork in rural Uganda. Experienced field teams from the Uganda Ministry of Health will co-lead the primary data collection with the primary supervisor.

PROSPECTIVE  STUDENT

The ideal candidate will have a Master’s degree in statistics/epidemiology/public health or a related discipline. This post is particularly suited to someone with a clinical background.

Supervisor

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