NIHR Health Protection Research Unit (HPRU) in Blood-Borne and Sexually Transmitted Infections
The NIHR HPRU is a partnership between UCL and Public Health England (PHE). Researchers in the NIHR HPRU aim to conduct state-of-the art research on sexually transmitted infections (STIs) and blood-borne viruses (BBVs) to improve the health of the population and to help develop practical policy guidelines for those working in health protection. The culture of the NIHR HPRU is one of working across different disease areas, populations, and academic institutions with the aim of providing a legacy of world-leading public health research in the field. The NIHR HPRU team includes researchers in the fields of clinical medicine, epidemiology, medical statistics, qualitative science, social science, health economics, mathematical modelling and laboratory science. The NIHR HPRU is led by Professor Caroline Sabin (Director) and Dr John Saunders (PHE Lead), supported by a Steering Committee comprising leading researchers in the field across the two institutes, and with research structured around three main themes of: A. Understanding risk and risk reduction for STIs and BBVs; B. Reducing the burden of undiagnosed STIs and BBVs; and C. Improving the care and management of those diagnosed with infections. To support our objective of developing research capacity in this field, the HPRU Academy (of which all HPRU PhD students are members) provides training opportunities for Academy Students and offers additional support to students, particularly when applying for post-doctoral fellowships.
Project description
HCV can cause liver scarring and cancer but is now curable with direct acting antiviral (DAA) therapies. In England, around 89,000 people were living with HCV in 2019, with numbers reducing most likely due to expanding access to DAA. However, PHE data show that among people who inject drugs, the subpopulation most affected by HCV transmission in England, the rate of new infections has been stable since 2011, and this threatens to derail the UK’s commitment to WHO targets of a 90% reduction in new cases by 2030. As HCV is a highly diverse virus, there is also the potential for resistant viral strains to emerge in response to drug therapies, compromising the elimination program. There is therefore an urgent need to characterise clinical, epidemiological and viral genomic factors and their impacts on treatment outcomes in England to inform preventative and therapeutic strategies which will ensure achievement of 2030 targets. We hypothesise that the roll-out of DAA could result in significant changes to the landscape of the HCV epidemic in the UK, as susceptible viral strains are eliminated and those with resistance characteristics or imported from other countries become dominant, which could pose a challenge to the HCV elimination agenda. In addition, we propose that the use of whole genome sequencing data will help understand HCV transmission dynamics, including distinguishing between relapse and reinfection, and allowing estimation of rates of reinfection and mixed infections in key risk groups, such as people who inject drugs and men who have sex with men, thereby informing focused public health interventions. Thus, the aim of this PhD is to establish a database of PHE’s HCV genomic data linked to socio-epidemiological and clinical data from the HCV Registry, which will then be used to support a whole genome sequencing study of the background isolates pre- and post-DAA therapy roll out period. This will be followed by an analysis of possible factors, including viral genetics, associated with treatment outcome, and a phylogenetic analysis to determine the impact of the rollout of DAA therapies and the COVID-19 pandemic on the UK HCV epidemic.
Person specification
Applicants should have a first or upper second-class degree in quantitative or life sciences discipline and/or a MSc in mathematical modelling and statistics, genetics and evolution, epidemiology or computational methods.
Eligibility
UK nationals.