Philippa C Matthews

Philippa C Matthews
University of Oxford | OX · Nuffield Department of Clinical Medicine

BSc BMBS DTM&H FRCP FRCPath DPhil

About

363
Publications
64,152
Reads
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9,977
Citations
Citations since 2017
274 Research Items
8026 Citations
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Introduction
I am an Associate Professor and Wellcome Trust Clinical Research Fellow in Oxford, studying the epidemiology, clinical impact and T cell immunology of Hepatitis B virus infections in populations in the UK and in South Africa. I continue a regular commitment to clinical work, where I have a variety of interests, including antimicrobial therapy and management of bone and joint infection. I am also interested in improving routes to open access publication and data visualisation, and promoting public engagement in science.
Additional affiliations
August 2016 - present
University of Oxford
Position
  • Wellcome Trust Clinical Research Fellow
January 2012 - July 2015
University of Oxford
Position
  • NIHR Academic Clinical Lecturer; Honorary Specialist Registrar in Infectious Diseases
October 2006 - September 2010
University of Oxford
Position
  • Junior Clinical Fellow
Education
October 2006 - September 2009
University of Oxford
Field of study
  • Clinical Medicine
January 2004 - May 2004
University of Liverpool
Field of study
  • Tropical Medicine
September 1995 - July 2000
University of Nottingham
Field of study
  • Medicine

Publications

Publications (363)
Book
Full-text available
The Tropical Medicine Notebook provides a concise overview of the key topics in tropical medicine using short notes, diagrams, maps, and tables. The book is divided into eight sections. The first five cover infections caused by bacteria, viruses, fungi, protozoa, and helminths. The following three present the topics of vector biology, disease syndr...
Article
Full-text available
Increased clinical and scientific scrutiny is being applied to hepatitis B virus (HBV), with focus on the development of new therapeutic approaches, ultimately aiming for cure. Defining the optimum natural CD8+ T cell immune responses that arise in HBV, mediated by HLA class I epitope presentation, may help to inform novel immunotherapeutic strateg...
Conference Paper
Full-text available
Anti-Retroviral Therapy (ART) has dramatically reduced morbidity and mortality associated with HIV/AIDS. However, this has left a niche for the emergence of liver disease in HIV-positive individuals co-infected with HBV. Despite the geographical overlap between highly endemic HBV and HIV in Southern Africa, there is a wide range in the prevalence o...
Article
Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in...
Article
Full-text available
Background: In South Africa, the first HBV vaccine dose is administered at age 6 weeks, leaving a potential window for vertical transmission. Insights into HBV seroprevalence in the vulnerable HIV-infected group are important to drive improvements in surveillance, treatment and prevention. Objectives: We set out to implement a screening program...
Preprint
Full-text available
Background: HIV and hepatitis B virus (HBV) prevalence are high in KwaZulu-Natal (KZN), South Africa. HIV co-infection negatively impacts HBV prognosis, and can increase likelihood of HBV mother-to-child-transmission (MTCT). In an established early treatment intervention cohort of HIV-transmitting mother-child pairs in KZN, we characterised HBV ser...
Article
Full-text available
Background The COVID-19 pandemic is rapidly evolving, with emerging variants and fluctuating control policies. Real-time population screening and identification of groups in whom positivity is highest could help monitor spread and inform public health messaging and strategy.
Article
Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We aimed to i) extract and summarise existing national HBV prevalence estimates, ii) add a new estimate based on primary c...
Article
Full-text available
High profile international goals have been set for the elimination of hepatitis B virus (HBV) infection as a public health threat by the year 2030. Developing and expanding equitable, accessible translational HBV research programmes that represent real-world populations are therefore an urgent priority for clinical and academic communities. We pres...
Preprint
Full-text available
Population-representative estimates of SARS-CoV-2 infection prevalence and antibody levels in specific geographic areas at different time points are needed to optimise policy responses. However, even population-wide surveys are potentially impacted by biases arising from differences in participation rates across key groups. Here, we use spatio-temp...
Preprint
Full-text available
Hepatitis B Virus (HBV) genome sequencing can be used to provide more complete genetic information at the population and individual level to shed light on the limitations of current interventions, and inform new strategies for elimination. HBV sequencing is challenging due to the partially dsDNA genome, high diversity, low viral loads and presence...
Article
Full-text available
Hepatitis B virus (HBV) infection represents a significant global health threat, accounting for 300 million chronic infections and up to 1 million deaths each year. HBV disproportionately affects people who are under-served by health systems due to social exclusion, and can further amplify inequities through its impact on physical and mental health...
Article
Background: Both infection and vaccination, alone or in combination, generate antibody and T cell responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the maintenance of such responses-and hence protection from disease-requires careful characterization. In a large prospective study of UK healthcare workers (HCWs...
Article
Full-text available
The aim of this systematic review and meta-analysis is to evaluate available prevalence and viral sequencing data representing chronic hepatitis B (CHB) infection in Kenya. More than 20% of the global disease burden from CHB is in Africa, however there is minimal high quality seroprevalence data from individual countries and little viral sequencing...
Article
Full-text available
In sub-Saharan Africa, simple biomarkers of liver fibrosis are needed to scale-up hepatitis B treatment. We conducted an individual participant data meta-analysis of 3,548 chronic hepatitis B patients living in eight sub-Saharan African countries to assess the World Health Organization-recommended aspartate aminotransferase-to-platelet ratio index...
Article
Hepatitis B viruses (HBVs) are compact viruses with circular genomes of ∼3.2 kb in length. Four genes (HBx, Core, Surface, and Polymerase) generating seven products are encoded on overlapping reading frames. Ten HBV genotypes have been characterised (A-J), which may account for differences in transmission, outcomes of infection, and treatment respo...
Article
Full-text available
The increasing frequency and magnitude of viral outbreaks in recent decades, epitomized by the COVID-19 pandemic, has resulted in an urgent need for rapid and sensitive diagnostic methods. Here, we present a methodology for virus detection and identification that uses a convolutional neural network to distinguish between microscopy images of fluore...
Article
Full-text available
Hepatitis B viruses (HBV) are compact viruses with circular genomes of ~3.2kb in length. Four genes (HBx, Core, Surface and Polymerase) generating seven products are encoded on overlapping reading frames. Ten HBV genotypes have been characterised (A-J), which may account for differences in transmission, outcomes of infection, and treatment response...
Preprint
Full-text available
Following primary SARS-CoV-2 vaccination, understanding the relative extent of protection against SARS-CoV-2 infection from boosters or from breakthrough infections (i.e. infection in the context of previous vaccination) has important implications for vaccine policy. In this study, we investigated correlates of protection against Omicron BA.4/5 inf...
Article
Full-text available
During the first half of 2022, the World Health Organization reported an outbreak of acute severe hepatitis of unknown aetiology (AS-Hep-UA) in children, following initial alerts from the United Kingdom (UK) where a cluster of cases was first observed in previously well children aged <6 years. Sporadic cases were then reported across Europe and wor...
Article
Full-text available
Background and research aim The incidence and mortality of liver cancer have been increasing in the UK in recent years. However, liver cancer is still under-studied. The Early Detection of Hepatocellular Liver Cancer (DeLIVER-QResearch) project aims to address the research gap and generate new knowledge to improve early detection and diagnosis of p...
Conference Paper
Full-text available
Background and aims: Only a few patients with compensated cirrhosis who underwent esophagogastroduodenoscopy (EGD) screening for varices were found to have varices needing treatment (VNT). Our study aimed to identify a novel machine learning-based model (ML EGD) for ruling out VNT and avoiding unnecessary EGD in patients with compensated cirrhosis....
Preprint
Full-text available
Background: Monitoring infection trends is vital to informing public health strategy. Detecting and quantifying changes in growth rates can inform policymakers' rationale for implementing or continuing interventions aimed at reducing impact. Substantial changes in SARS-CoV-2 prevalence with emergence of variants provides opportunity to investigate...
Preprint
Full-text available
Background Chronic hepatitis B infection (CHB) is the leading global cause of hepatocellular carcinoma (HCC), however the CHB population in the UK is not well characterised, and few investigations of risk factors for progression to HCC in multiethnic populations have been undertaken. Methods We identified CHB individuals from the English primary c...
Article
Full-text available
Background Direct evaluation of vascular inflammation in patients with COVID-19 would facilitate more efficient trials of new treatments and identify patients at risk of long-term complications who might respond to treatment. We aimed to develop a novel artificial intelligence (AI)-assisted image analysis platform that quantifies cytokine-driven va...
Preprint
Full-text available
Background: The National Institute for Health Research Health Informatics Collaborative (NIHR HIC) viral hepatitis theme is working to overcome governance and data challenges to collate routine clinical data from electronic patients records from multiple UK hospital sites for translational research. The development of hepatocellular carcinoma (HCC)...
Article
Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We summarised datasets that are available to represent UK CHB epidemiology, considering differences between sources, and d...
Article
Full-text available
Circadian rhythms influence and coordinate an organism’s response to its environment and to invading pathogens. We studied the diurnal variation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in nasal/throat swabs collected in late 2020 to spring 2021 in a population immunologically naïve to SARS-CoV-2 and prior to widespread v...
Article
Background: The SARS-CoV-2 Delta variant has been replaced by the highly transmissible Omicron BA.1 variant, and subsequently by Omicron BA.2. It is important to understand how these changes in dominant variants affect reported symptoms, while also accounting for symptoms arising from other co-circulating respiratory viruses. Methods: In a natio...
Preprint
Hepatitis B viruses (HBV) are compact viruses with circular genomes of ∼3.2kb in length. Four genes (HBx, Core, Surface and Polymerase) generating seven products are encoded on overlapping reading frames. Ten HBV genotypes have been characterised (A-J), which may account for differences in transmission, outcomes of infection, and treatment response...
Article
Full-text available
Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, a...
Article
Full-text available
Key Messages: The National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) has established a cohort of individuals with chronic hepatitis B virus (HBV) infection in secondary care in the UK, providing a resource for translational research. The dataset comprises >6000 individuals (99% adults aged 18–88, 1% children aged...
Preprint
Both infection and vaccination, alone or in combination, generate antibody and T cell responses against SARS–CoV–2. However, the maintenance of such responses – and hence protection from disease – requires careful characterisation. In a large prospective study of UK healthcare workers (PITCH, within the larger SIREN study) we previously observed th...
Article
Full-text available
Given high SARS-CoV-2 incidence, coupled with slow and inequitable vaccine roll-out in many settings, there is a need for evidence to underpin optimum vaccine deployment, aiming to maximise global population immunity. We evaluate whether a single vaccination in individuals who have already been infected with SARS-CoV-2 generates similar initial and...
Article
Full-text available
The role of immune responses to previously seen endemic coronavirus epitopes in severe acute respiratory coronavirus 2 (SARS-CoV-2) infection and disease progression has not yet been determined. Here, we show that a key characteristic of fatal coronavirus disease (COVID-19) outcomes is that the immune response to the SARS-CoV-2 spike protein is enr...
Article
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV). HBV is a substantial global health problem, with close to 300 million people chronically infected, and accounting for a million deaths each...
Article
Full-text available
Antibody responses are an important part of immunity after Coronavirus Disease 2019 (COVID-19) vaccination. However, antibody trajectories and the associated duration of protection after a second vaccine dose remain unclear. In this study, we investigated anti-spike IgG antibody responses and correlates of protection after second doses of ChAdOx1 o...
Article
Antibody responses are an important part of immunity after Coronavirus Disease 2019 (COVID-19) vaccination. However, antibody trajectories and the associated duration of protection after a second vaccine dose remain unclear. In this study, we investigated anti-spike IgG antibody responses and correlates of protection after second doses of ChAdOx1 o...
Article
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV). HBV is a substantial global health problem, with close to 300 million people chronically infected, and accounting for a million deaths each...
Preprint
Full-text available
Background HBV is the leading global cause of cirrhosis and primary liver cancer. The virus’s attributable disease burden in the UK is concentrated in vulnerable populatons including ethinic minorities, people experiencing homelessness and people born in high-prevalence countries. Despite this the UK HBV population has not been well characterised,...
Article
Full-text available
Hepatitis B virus (HBV) polymerase is divided into terminal protein, spacer, reverse transcriptase, and RNase domains. Spacer has previously been considered dispensable, merely acting as a tether between other domains or providing plasticity to accommodate deletions and mutations. We explore evidence for the role of spacer sequence, structure, and...
Preprint
Full-text available
Sub-Saharan Africa accounts for around 20% of the global disease burden from chronic hepatitis B infection (CHB), however there is minimal high quality seroprevalence data from individual countries and little viral sequencing data available. We undertook a systematic review of the prevalence and genetic data available for hepatitis B virus (HBV) in...
Preprint
Full-text available
Objective In sub-Saharan Africa, hepatitis B is the principal cause of liver disease. Non-invasive biomarkers of liver fibrosis are needed to identify patients requiring antiviral treatment. We assessed aspartate aminotransferase-to-platelet ratio index (APRI), gamma-glutamyl transferase-to-platelet ratio (GPR) and FIB-4 to diagnose significant fib...
Article
Full-text available
The trajectories of acquired immunity to severe acute respiratory syndrome coronavirus 2 infection are not fully understood. We present a detailed longitudinal cohort study of UK healthcare workers prior to vaccination, presenting April-June 2020 with asymptomatic or symptomatic infection. Here we show a highly variable range of responses, some of...
Article
Full-text available
Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatur...
Article
Background: To determine the impact of the COVID-19 pandemic on the population with chronic Hepatitis B virus (HBV) infection under hospital follow-up in the UK, we quantified the coverage and frequency of measurements of biomarkers used for routine surveillance (alanine transferase [ALT] and HBV viral load). Methods: We used anonymized electronic...
Article
Full-text available
Background The COVID-19 pandemic is rapidly evolving, with emerging variants and fluctuating control policies. Real-time population screening and identification of groups in whom positivity is highest could help monitor spread and inform public health messaging and strategy. Methods To develop a real-time screening process, we included results fro...
Article
Sexual dimorphism in infectious diseases refers to the different infection susceptibilities and outcomes between males and females, and has been described for many pathogens, including hepatitis B virus (HBV) infection. HBV is a substantial global health problem, with close to 300 million people infected, and accounting for a million deaths each ye...
Preprint
Background and research aim The incidence and mortality of liver cancer have been increasing in recent years in the UK. However, liver cancer is still under-studied. The Early De tection of Hepatocellular Liver Cancer (DeLIVER-QResearch) project aims to address the research gap and generate new knowledge to improve early detection and diagnosis of...
Article
Full-text available
Background: Necrotising otitis externa is a severe ear infection for which there are no established diagnostic or treatment guidelines. Method: This study described clinical characteristics, management and outcomes for patients managed as necrotising otitis externa cases at a UK tertiary referral centre. Results: A total of 58 (63 per cent) pa...
Preprint
Full-text available
Background The SARS-CoV-2 Delta variant has been replaced by the highly transmissible Omicron BA.1 variant, and subsequently by Omicron BA.2. It is important to understand how these changes in dominant variants affect reported symptoms, while also accounting for symptoms arising from other co-circulating respiratory viruses. Methods In a nationall...
Article
Full-text available
Background Previous infection with SARS-CoV-2 affects the immune response to the first dose of the SARS-CoV-2 vaccine. We aimed to compare SARS-CoV-2-specific T-cell and antibody responses in health-care workers with and without previous SARS-CoV-2 infection following a single dose of the BNT162b2 (tozinameran; Pfizer–BioNTech) mRNA vaccine. Method...
Article
Full-text available
The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global crisis with unprecedented challenges for public health. Vaccinations against SARS-CoV-2 have slowed the incidence of new infections and reduced disease severity. As the time of day of vaccination has been reported to influence host immune respon...
Article
Full-text available
The effectiveness of the BNT162b2 and ChAdOx1 vaccines against new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections requires continuous re-evaluation, given the increasingly dominant B.1.617.2 (Delta) variant. In this study, we investigated the effectiveness of these vaccines in a large, community-based survey of randomly sel...
Preprint
Full-text available
The physiological effects of vaccination against SARS-CoV-2 (COVID-19) are well documented, yet the behavioural effects are largely unknown. Risk compensation suggests that gains in personal safety, as a result of vaccination, are offset by increases in risky behaviour, such as socialising, commuting and working outside the home. This is potentiall...
Preprint
Full-text available
Background and aims: To determine the impact of the COVID-19 pandemic on the population with chronic Hepatitis B virus (HBV) infection under hospital follow-up in the UK, we quantified the coverage and frequency of measurements of biomarkers used for routine surveillance (ALT and HBV viral load). Methods: We used anonymised electronic health record...
Article
Full-text available
Background ‘Classic’ symptoms (cough, fever, loss of taste/smell) prompt SARS-CoV-2 PCR-testing in the UK. Studies have assessed the ability of different symptoms to identify infection, but few have compared symptoms over time (reflecting variants) and by vaccination status. Methods Using the COVID-19 Infection Survey, sampling households across t...
Article
BACKGROUND: “Classic” symptoms (cough, fever, loss of taste/smell) prompt severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing in the United Kingdom. Studies have assessed the ability of different symptoms to identify infection, but few have compared symptoms over time (reflecting variants) and by vac...