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MORU Tropical Health Network researchers in Southeast Asia study various aspects of hepatitis B and C, infections that can lead to chronic liver diseases, and complications like liver cancer or cirrhosis. Researchers at MOCRU work on treatment for hepatitis C, a frequent opportunistic infection in HIV patients. MORU’s Clinical Pharmacology conducts two trials on possible treatments of hepatitis C. Hepatitis B is frequently transmitted from mother to child at birth, and SMRU researchers study mothers’ knowledge and behaviour, as well as prevention.

Community engagement, health education provided at a brothel
A MOCRU/Medical Action Myanmar worker provides sex workers with health education in a brothel in Hpakant, a large jade mine area in Myanmar

The burden of hepatitis B and C remains high in Southeast Asia, with the WHO estimating 39 million people infected with chronic hepatitis B in 2019, 10 million with hepatitis C, and 410,000 people dying due to viral hepatitis annually.

HIV in Myanmar is largely concentrated among female sex workers, men having sex with men and intravenous drug users. HIV infection rates are high, up to 40% in Yangon and north Myanmar, and co-infection rates with hepatitis C (HCV) reach up to 78% in the far north of Myanmar. MOCRU (Myanmar Oxford Clinical Research Unit) researchers are exploring a comprehensive package of integrated HIV/TB/HCV/STI (sexually transmitted infections) prevention and treatment services, provided to high-risk populations at clinics and in remote communities. Community-based health workers increase the uptake of prevention services and support compliance of long-term treatments (pictured above).

MORU’s Clinical Pharmacology department conducts clinical trials on hepatitis C. Two ongoing trials in Vietnam and Myanmar investigate the efficacy and safety of sofosbuvir and daclatasvir in the treatment of hepatitis C. Bioanalytical assays will be developed to quantify these drugs in plasma and whole blood. Pharmacokinetic and pharmacodynamic samples will be collected to evaluate their pharmacokinetic properties, and link them to their pharmacodynamic effect (viral elimination).

To prevent mother to child transmission of hepatitis B, researchers at SMRU (Shoklo Malaria Research Unit) at the border between Thailand and Myanmar examine knowledge, attitude and practice of mothers, and assess the cost-effectiveness of tenofovir to prevent hepatitis B.