The busy clinical hepatitis service at Liverpool Hospital has formed the platform for significant clinical hepatitis research and the establishment of the Hepatitis Research Group (HRG) under the leadership of Associate Professor Miriam Levy.
Research has included investigation of hepatitis B Virus (HBV) infection in pregnancy, where we are international leaders. The HRG has defined, for the first time in Australia, the rate of HBV perinatal transmission despite passive/active immunoprophylaxis and identified that high maternal load is the most significant risk for transmission. The Group has demonstrated that the use of antiviral therapy in the last trimester can reduce the transmission of HBV infection.
The safety and efficacy of different agents is under examination in collaboration with the national virological reference laboratory, VIDRL. The impact of pregnancy, and the postpartum period, because of its unique immunological and hormonal milieu, on HBV replication is under examination. The HRG has examined the rate and character of postpartum flares of hepatitis, to understand their impact on the natural history of HBV infection in pregnancy which is suspected to be different from that described in standard liver clinic cohorts, which are dominated by males. A number of papers have been published and grants secured in this field and work is ongoing.
The Group is very involved in patient health literacy, and has produced novel tools for patients to understand their hepatitis, including YouTube videos and mobile apps. The production and evaluation of these materials forms part of our research.
The Group also utilises cutting edge technology including Fibroscan and Shear Wave ultrasound to non-invasively identify liver fibrosis for clinical and research purposes. We use these tools to further characterise our viral hepatitis B cohort and determine its role in algorithms of chronic HBV.
The HRG is also participating in a number of clinical drug trials using new agents for chronic HBV and HCV infection. This reflects the rapid changes in therapeutics in this field and will allow patients to access new therapies.
A study by Associate Professor John Quin examining the role of immune stimulation in inducing HBV treatment responses is currently underway.