Publications by year
In Press
Jones CR, Hamilton FW, Thompson A, Morris TT, Moran E (In Press). Seroprevalence of SARS-CoV-2 IgG in healthcare workers and other staff at North Bristol NHS Trust: a sociodemographic analysis.
Abstract:
Seroprevalence of SARS-CoV-2 IgG in healthcare workers and other staff at North Bristol NHS Trust: a sociodemographic analysis
Structured summaryBackgroundHealthcare workers (HCWs) are at increased risk of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). There are limited data exploring the relative impact of geographical and socioeconomic factors on risk of SARS-CoV-2 infection among HCWs.AimTo estimate and explore SARS-CoV-2 IgG antibody seroprevalence in HCWs and support staff at a hospital in South West England.MethodsWe conducted a nested cross-sectional study from May-July 2020. Inverse probability weighted regression was used to estimate seroprevalence of SARS-CoV-2 and associations with demographic and socioeconomic risk factors that were robust to selection into testing.FindingsAttendance for testing varied by demographic and socioeconomic factors. The overall rate of SARS-CoV-2 IgG seroprevalence among tested staff was 9.3% (638/6858). The highest seroprevalence was found in wards associated with SARS-CoV-2 outbreaks and among junior staff with patient-facing roles. Black, Asian and Minority Ethnic (BAME) staff had increased odds of SARS-CoV-2 seroprevalence (adjusted OR: 1.99, 95%CI: 1.69, 2.34; p<0.001) relative to White staff, except for those categorised as Medical/Dental. We found a significant association between neighbourhood deprivation and seroprevalence (p<0.01). Seroprevalence ranged from 12% in staff residing in areas with the greatest relative deprivation to 8.4% in the least deprived.ConclusionTransmission between staff groups is evident within the healthcare setting. BAME individuals were at increased risk of infection with SARS-CoV-2. Work role, area of residence, and neighbourhood deprivation all contribute to SARS-CoV-2 infection risk. As hospitals introduce routine staff SARS-CoV-2 testing they should consider differential uptake of testing among staff groups.
Abstract.
2021
Jones CR, Hamilton FW, Thompson A, Morris TT, Moran E (2021). SARS-CoV-2 IgG seroprevalence in healthcare workers and other staff at North Bristol NHS Trust: a sociodemographic analysis.
J Infect,
82(3), e24-e27.
Author URL.
Cooke GS, Pett S, McCabe L, Jones C, Gilson R, Verma S, Ryder SD, Collier JD, Barclay ST, Ala A, et al (2021). Strategic treatment optimization for HCV (STOPHCV1): a randomised controlled trial of ultrashort duration therapy for chronic hepatitis C.
Wellcome Open Research,
6, 93-93.
Abstract:
Strategic treatment optimization for HCV (STOPHCV1): a randomised controlled trial of ultrashort duration therapy for chronic hepatitis C
Background: The World Health Organization (WHO) has identified the need for a better understanding of which patients with hepatitis C virus (HCV) can be cured with ultrashort course HCV therapy. Methods: A total of 202 individuals with chronic HCV were randomised to fixed-duration shortened therapy (8 weeks) vs variable-duration ultrashort strategies (VUS1/2). Participants not cured following first-line treatment were retreated with 12 weeks’ sofosbuvir/ledipasvir/ribavirin. The primary outcome was sustained virological response 12 weeks (SVR12) after first-line treatment and retreatment. Participants were factorially randomised to receive ribavirin with first-line treatment. Results: All evaluable participants achieved SVR12 overall (197/197, 100% [95% CI 98-100]) demonstrating non-inferiority between fixed-duration and variable-duration strategies (difference 0% [95% CI -3.8%, +3.7%], 4% pre-specified non-inferiority margin). First-line SVR12 was 91% [86%-97%] (92/101) for fixed-duration vs 48% [39%-57%] (47/98) for variable-duration, but was significantly higher for VUS2 (72% [56%-87%] (23/32)) than VUS1 (36% [25%-48%] (24/66)). Overall, first-line SVR12 was 72% [65%-78%] (70/101) without ribavirin and 68% [61%-76%] (69/98) with ribavirin (p=0.48). At treatment failure, the emergence of viral resistance was lower with ribavirin (12% [2%-30%] (3/26)) than without (38% [21%-58%] (11/29), p=0.01). Conclusions: Unsuccessful first-line short-course therapy did not compromise retreatment with sofosbuvir/ledipasvir/ribavirin (100% SVR12). SVR12 rates were significantly increased when ultrashort treatment varied between 4-7 weeks rather than 4-6 weeks. Ribavirin significantly reduced resistance emergence in those failing first-line therapy. ISRCTN Registration: 37915093 (11/04/2016).
Abstract.
Cooke GS, Pett S, McCabe L, Jones C, Gilson R, Verma S, Ryder SD, Collier JD, Barclay ST, Ala A, et al (2021). Strategic treatment optimization for HCV (STOPHCV1): a randomised controlled trial of ultrashort duration therapy for chronic hepatitis C.
Wellcome Open Research,
6, 93-93.
Abstract:
Strategic treatment optimization for HCV (STOPHCV1): a randomised controlled trial of ultrashort duration therapy for chronic hepatitis C
Background: The world health organization (WHO) has identified the need for a better understanding of which patients with hepatitis C virus (HCV) can be cured with ultrashort course HCV therapy. Methods: A total of 202 individuals with chronic HCV were randomised to fixed-duration shortened therapy (8 weeks) vs variable-duration ultrashort strategies (VUS1/2). Participants not cured following first-line treatment were retreated with 12 weeks’ sofosbuvir/ledipasvir/ribavirin. The primary outcome was sustained virological response 12 weeks (SVR12) after first-line treatment and retreatment. Participants were factorially randomised to receive ribavirin with first-line treatment. Results: All evaluable participants achieved SVR12 overall (197/197, 100% [95% CI 98-100]) demonstrating non-inferiority between fixed-duration and variable-duration strategies (difference 0% [95% CI -3.8%, +3.7%], 4% pre-specified non-inferiority margin). First-line SVR12 was 91% [86%-97%] (92/101) for fixed-duration vs 48% [39%-57%] (47/98) for variable-duration, but was significantly higher for VUS2 (72% [56%-87%] (23/32)) than VUS1 (36% [25%-48%] (24/66)). Overall, first-line SVR12 was 72% [65%-78%] (70/101) without ribavirin and 68% [61%-76%] (69/98) with ribavirin (p=0.48). At treatment failure, the emergence of viral resistance was lower with ribavirin (12% [2%-30%] (3/26)) than without (38% [21%-58%] (11/29), p=0.01). Conclusions: Unsuccessful first-line short-course therapy did not compromise retreatment with sofosbuvir/ledipasvir/ribavirin (100% SVR12). SVR12 rates were significantly increased when ultrashort treatment varied between 4-7 weeks rather than 4-6 weeks. Ribavirin significantly reduced resistance emergence in those failing first-line therapy. ISRCTN Registration: 37915093 (11/04/2016).
Abstract.
2020
Smith DA, Wang T, Freeman O, Crichton C, Salih H, Matthews PC, Davies J, Várnai KA, Woods K, Jones CR, et al (2020). National Institute for Health Research Health Informatics Collaborative: development of a pipeline to collate electronic clinical data for viral hepatitis research.
BMJ Health & Care Informatics,
27(3), e100145-e100145.
Abstract:
National Institute for Health Research Health Informatics Collaborative: development of a pipeline to collate electronic clinical data for viral hepatitis research
ObjectiveThe National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) is a programme of infrastructure development across NIHR Biomedical Research Centres. The aim of the NIHR HIC is to improve the quality and availability of routinely collected data for collaborative, cross-centre research. This is demonstrated through research collaborations in selected therapeutic areas, one of which is viral hepatitis.DesignThe collaboration in viral hepatitis identified a rich set of datapoints, including information on clinical assessment, antiviral treatment, laboratory test results and health outcomes. Clinical data from different centres were standardised and combined to produce a research-ready dataset; this was used to generate insights regarding disease prevalence and treatment response.ResultsA comprehensive database has been developed for potential viral hepatitis research interests, with a corresponding data dictionary for researchers across the centres. An initial cohort of 960 patients with chronic hepatitis B infections and 1404 patients with chronic hepatitis C infections has been collected.ConclusionFor the first time, large prospective cohorts are being formed within National Health Service (NHS) secondary care services that will allow research questions to be rapidly addressed using real-world data. Interactions with industry partners will help to shape future research and will inform patient-stratified clinical practice. An emphasis on NHS-wide systems interoperability, and the increased utilisation of structured data solutions for electronic patient records, is improving access to data for research, service improvement and the reduction of clinical data gaps.
Abstract.
2019
Jones CR, Ortega-Prieto AM, Cooke G, Dorner M (2019). A phenotypic resistance assay for clinical HCV isolates could help rationalise DAA therapy in individuals experiencing recurrent virologic failure.
Author URL.
Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, Dusheiko G, Feld JJ, Gore C, Griswold MG, et al (2019). Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission.
Lancet Gastroenterol Hepatol,
4(2), 135-184.
Abstract:
Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission.
Viral hepatitis is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. Highly effective prevention measures and treatments have made the global elimination of viral hepatitis a realistic goal, endorsed by all WHO member states. Ambitious targets call for a global reduction in hepatitis-related mortality of 65% and a 90% reduction in new infections by 2030. This Commission draws together a wide range of expertise to appraise the current global situation and to identify priorities globally, regionally, and nationally needed to accelerate progress. We identify 20 heavily burdened countries that account for over 75% of the global burden of viral hepatitis. Key recommendations include a greater focus on national progress towards elimination with support given, if necessary, through innovative financing measures to ensure elimination programmes are fully funded by 2020. In addition to further measures to improve access to vaccination and treatment, greater attention needs to be paid to access to affordable, high-quality diagnostics if testing is to reach the levels needed to achieve elimination goals. Simplified, decentralised models of care removing requirements for specialised prescribing will be required to reach those in need, together with sustained efforts to tackle stigma and discrimination. We identify key examples of the progress that has already been made in many countries throughout the world, demonstrating that sustained and coordinated efforts can be successful in achieving the WHO elimination goals.
Abstract.
Author URL.
Jones CR, Flower BF, Barber E, Simmons B, Cooke GS (2019). Treatment optimisation for hepatitis C in the era of combination direct-acting antiviral therapy: a systematic review and meta-analysis.
Wellcome Open Research,
4, 132-132.
Abstract:
Treatment optimisation for hepatitis C in the era of combination direct-acting antiviral therapy: a systematic review and meta-analysis
Background: Prior to direct-acting antiviral (DAA) therapy, personalised medicine played an important role in the treatment of hepatitis C virus (HCV). Whilst simplified treatment strategies are central to treatment scale-up, some patients will benefit from treatment optimisation. This systematic review and meta-analysis explores treatment optimisation strategies in the DAA era. Methods: We systematically searched Medline, Embase, and Web of Science for studies that adopted a stratified or personalised strategy using a licensed combination DAA regimen, alone or with additional agents. We performed a thematic analysis to classify optimisation strategies and a meta-analysis of sustained virologic response rates (SVR), exploring heterogeneity with subgroup analyses and meta-regression. Results: We included 64 studies (9450 participants). Thematic analysis found evidence of three approaches: duration, combination, and/or dose optimisation. We separated strategies into those aiming to maintain SVR in the absence of predictors of failure, and those aiming to improve SVR in the presence of predictors of failure. Shortened duration regimens achieve pooled SVR rates of 94.2% (92.3-95.9%) for 8 weeks, 81.1% (75.1-86.6%) for 6 weeks, and 63.1% (39.9-83.7%) for ≤4 weeks. Personalised strategies (100% vs 87.6%; p<0.001) and therapy shortened according to ≥3 host/viral factors (92.9% vs 81.4% or 87.2% for 1 or 2 host/viral factors, respectively; p=0.008) offer higher SVR rates when shortening therapy. Hard-to-treat HCV genotype 3 patients suffer lower SVR rates despite treatment optimisation (92.6% vs 98.2%; p=0.001). Conclusions: Treatment optimisation for individuals with multiple predictors of treatment failure can offer high SVR rates. More evidence is needed to identify with confidence those individuals in whom SVR can be achieved with shortened duration treatment.
Abstract.
2018
Heffernan A, Barber E, Cook NA, Gomaa AI, Harley YX, Jones CR, Lim AG, Mohamed Z, Nayagam S, Ndow G, et al (2018). Aiming at the Global Elimination of Viral Hepatitis: Challenges Along the Care Continuum.
Open Forum Infect Dis,
5(1).
Abstract:
Aiming at the Global Elimination of Viral Hepatitis: Challenges Along the Care Continuum.
A recent international workshop, organized by the authors, analyzed the obstacles facing the ambitious goal of eliminating viral hepatitis globally. We identified several policy areas critical to reaching elimination targets. These include providing hepatitis B birth-dose vaccination to all infants within 24 hours of birth, preventing the transmission of blood-borne viruses through the expansion of national hemovigilance schemes, implementing the lessons learned from the HIV epidemic regarding safe medical practices to eliminate iatrogenic infection, adopting point-of-care testing to improve coverage of diagnosis, and providing free or affordable hepatitis C treatment to all. We introduce Egypt as a case study for rapid testing and treatment scale-up: this country offers valuable insights to policy makers internationally, not only regarding how hepatitis C interventions can be expeditiously scaled-up, but also as a guide for how to tackle the problems encountered with such ambitious testing and treatment programs.
Abstract.
Author URL.
Jones CR, Cooke GS (2018). Hepatitis in the traveller. Medicine, 46(1), 20-23.
2012
Jones CR, Cardoso RB, Hüttner E, Oliveira HW, dos Santos MA, Helena Itaqui Lopes M, Russomano T (2012). Towards designing for equity: active citizen participation in eHealth. Transforming Government: People, Process and Policy, 6(4), 333-344.
2011
Russomano T, B R, R C, W H, Httner E, Itaqui Lopes MH (2011). eHealth Projects of the Microgravity Centre. In (Ed) Biomedical Engineering, Trends, Research and Technologies, InTech.
