Contacts

Professor Margaret Hellard AM

Deputy Director (Programs); Adjunct Professor, Monash University, DEPM.

Background

Infectious diseases - focus of her work

For almost two decades Margaret’s work has centred around infectious diseases, preventing their transmission and identifying the impact of these infections in vulnerable populations. A researcher and clinician, her principal research interests are in the epidemiology of blood-borne viruses (BBVs) HIV, hepatitis B and hepatitis C, sexually transmitted infections, and improving the management of individuals who already have the infection.

Margaret has considerable experience in undertaking community-based research involving young people, injecting drug users (IDUs) and vulnerable populations, and experience in research in tertiary care institutes. She also has considerable experience in undertaking research that used new technologies (such as SMS, Facebook) for health promotion and prevention interventions.

Translational Research

Margaret has over $73 million in competitive research grants and tenders. She was recently awarded an $11.3 million grant from the Paul Ramsey Foundation for hepatitis C elimination. She was also awarded a prestigious NHMRC Program Grant worth over $7 million. Margaret has over 440 peer reviewed publications including in high ranking journals such as the Lancet, GUT, Hepatology and Clinical Infectious Diseases. She has won prizes for her work including the Victorian Public Health Award for Program Excellence and VicHealth Award for Outstanding Achievement in Health Promotions.

Margaret has considerable experience in translating research outcomes into health policy and practice. Examples include:

  • Margaret’s work over the past 15 years increasing knowledge and understanding of viral hepatitis transmission, testing and care has influenced policy in Australia and globally. This includes being one of a small group of advisors instrumental in WHO setting elimination targets for hepatitis B and hepatitis C. Margaret is leading implementation science research to ensure Australia meets these elimination targets; she had received funding worth over $14 million dollars to undertake this work including a prestigious NHMRC Program Grant and a NHMRC Partnership Grant. A key feature of this work is to increase the number of people being tested and treated for hepatitis C in community settings, in particular highly marginalised and vulnerable groups such as people who inject drugs. Margaret is also collaborating with researchers and governments including Georgia, Myanmar, Iceland, Kenya, India and the Netherlands on projects aiming to eliminate hepatitis C as a public health threat.

  • Margaret’s work over the past ten years examining the role of the injecting network on hepatitis C transmission has led to the funding of the Hepatitis C Treatment and Prevention (TAP) Study. This world first study is examining the feasibility of a nurse led model of care for hepatitis C treatment of people who inject drugs in a community setting using a network-based approach.

  • The identification of high rates of hepatitis C reinfection in people who inject drugs led to changes in HCV prevention education and helped characterise T cell function, which in turn is informing HCV vaccine development.

  • Margaret has been instrumental in the development of innovative sentinel surveillance systems for blood borne viruses and sexually transmitted infections and sexually transmitted infections both in Victoria and nationally. This work has led to the Federal Government funding ACCESS, a highly innovative national surveillance program that is able to monitor changes in the incidence and prevalence of these diseases and the cascades of care. ACCESS enables governments to evaluate the impact of their programs aimed at eliminating blood borne viruses and controlling sexually transmitted infections.

  • Margaret’s work, with others, on the feasibility of treating current people who inject drugs for their HCV has led to changes in the clinical management of this group and influenced the Victorian Government to fund and locate ten hepatitis C nurses in community based integrated clinics. Most recently this work has led to funding for randomised controlled study comparing community-based hepatitis C treatment with patients treated in a tertiary setting (The Prime Study).

  • Margaret’s prison research and public health advocacy played an important role in the introduction of free HBV vaccine and public health nurses into Victorian Correctional Facilities and increasing the availability of HCV treatment into Victorian prisons.

  • Her development of health promotion projects using new technologies (The FaceSpace and Queer as FK projects) led the Victorian Government to fund the Victorian AIDS Council to continue the Queer as FK project on the Facebook social network site.

  • In 2000, Margaret saved Victoria over $500 million when the results of her PhD research The Water Quality Study demonstrated that Victoria’s drinking water did not require filtration.

Most significant publications

  1. Scott N, Sacks-Davis R, Wade AJ, Stoove M, Pedrana A, Doyle JS, Thompson AJ, Wilson DP, Hellard M. Australia needs to increase testing to achieve hepatitis C elimination. Med J Aust. May 2020. This study analysed MBS testing data and PBS treatment data, in combination with mathematical modelling, to assess Australia’s progress towards the 2030 hepatitis C elimination targets. The publications shows that Australia is unlikely to meet the WHO targets unless the identification and testing of people exposed to hepatitis C is increased by 50%.
  2. T Marukutira, N Scott, S Kelly, C Birungi, J Makhema, S Crowe, M Stoove, M Hellard. Modelling the impact of migrants on the success of the HIV care and treatment program in Botswana. PLoS One. 2020
  3. N Scott, M Stoove, S Kelly, D Wilson, M Hellard. Achieving 90-90-90 HIV targets will not be enough to achieve the HIV incidence reduction target in Australia CID March 2018. This publication outlines the difficulties Australia will have in obtaining the goal of ending HIV by 2030 without significant increases in programs such as pre-exposure prophylaxis, testing and treatment.
  4. Lim MSC, et al. (senior author) Young Australians’ use of pornography and associations with sexual risk behaviours. Aus NZ J Pub Health 2017. This Australian first study young people found that pornography viewing was very common and was associated with younger age at first sex, non-heterosexual identity, ever having anal intercourse, and recent mental health problems. The work has been cited extensively in senate and parliamentary enquiries
  5. N Scott, J Doyle, D Wilson, A Wade, J Howell, A Pedrana, A Thompson, M Hellard, Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade. International Journal of Drug Policy, 2017; 47, 107-116 This important model highlights the importance of upscaling testing if we are to achieve hepatitis C elimination in Australia and globally.
  6. K Dolan et al. Global burden of HIV, viral hepatitis and tuberculosis among prisoners and detainees. Lancet 2016. 388: 10049, 1089–1102 (Cit 55) This major review highlighted prisons as a high risk environment for BBVs and TB, and the importance of prevention and treatment programs.
  7. N Scott, E McBryde, A Thompson, J Doyle, M Hellard. Treatment scale-up to achieve global hepatitis C virus incidence and mortality elimination targets: a cost-effectiveness model. Gut 2017; Gut 66 (8), 1507-1515 Cit 20 This important model providing guidance to the government about the numbers of PWID who require treatment annually to achieve hepatitis C elimination as a public health goal. The methods used in the model have been used in Iceland, and are being used in Myanmar and India to model hepatitis C elimination.
  8. Hellard et al. The impact of injecting networks on hepatitis C transmission and treatment in people who inject drugs. Hepatol 2014; 60:1861-1870 (Cit: 59) This recently published ground-breaking paper showed that treating PWID and their injecting network impacts on HCV incidence and transmission. The findings led to the funding of the TAP Study, a world first ‘treatment as prevention’ intervention using a network-based approach.
  9. N Martin et al. HCV treatment for prevention among people who inject drugs: modeling treatment scale-up in the age of direct-acting antivirals, Hepatology, 2013; 58:1598-1609 (Cit 274) I played a central role in this international collaboration of this highly cited paper that uses mathematical modelling to inform the elimination of HCV in people who inject drugs.
    1. Aspinal et al (senior author). Treatment of HCV infection among people who are actively injecting drugs: A systematic review and meta-analysis. Clin Infect Dis 2013;57:s80-s89 (Cit 177). This paper complemented earlier work by my team showing PWID can be successfully treated for HCV.
  10. Sacks-Davis et al. (Senior Author) High rates of hepatitis C virus reinfection and spontaneous clearance of reinfection in people who inject drugs: a prospective cohort study. PLoS One 2013; v8(11). (Cit: 33 ) This important paper highlighted the dynamic nature of hepatitis C infection/reinfection. It provided insights into the transmission of infection within cohorts of PWID and the network impact of transmission.
  11. J Grebely et al. Hepatitis C virus clearance, reinfection, and persistence, with insights from studies of injecting drug users: towards a vaccine. Lancet Infectious Diseases 2012, 12: 408-414 (Cit 124) This paper provides important insight into what will be required to develop, trial and successfully implement a hepatitis C vaccine in PWID
  12. Lim M et al. A randomised controlled trial of the impact of text and email messaging on the sexual health of young people. J Epi Comm Health 2012;66:69-74 . Cit – 125 This world-first randomised controlled trial in a community-based setting found that SMS could be used to increase sexual health knowledge and health-seeking behaviour.
  13. A Pedrana et al. High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia. J AIDS 2012;59:94–99. Cit – 45 This paper identified that a significant proportion (30%) of HIV positive MSM did not know their HIV status leading to the development of new health promotion campaign for Victoria.
  14. GV Matthews et al. Patterns and characteristics of hepatitis C transmission clusters amongst HIV positive and HIV negative individuals in the Australian Trial in Acute Hepatitis C. Clin Infect Dis 2011;52(6):803–811 Cit 54 This paper provided important evidence about hepatitis C transmission in gay and bisexual men (GBM) in Australia. It informed hepatitis C elimination programs in this population; informed by this work I currently lead a hepatitis C elimination program in Melbourne and I recently established a global collaboration for hepatitis C elimination in HIV coinfection.
  15. Gold et al. Hellard. Determining the impact of text messaging for sexual health promotion to young people. Sex Transm Dis 2011;38(4):247-52 (Cit: 77) This large scale implementation study of over 6000 young people confirmed that SMS could be successfully used as a health promotion tool, outside of a formal clinical trial setting.
  16. Gold J et al. A Systematic Examination of the Use of Online Social Networking Sites for Sexual Health Promotion. BMC Public Health 2011, 11:58 Cit – 153 This world first study evaluated the use of online social networking sites as health promotion tools. Importantly it established a framework for evaluating online programs into the future. Cit – 153
  17. Dore, Hellard et al. Effective treatment of injecting drug users with recently acquired Hepatitis C virus infection. Gastroenterol 2010; 138:123–135 Cit: 139 I was the major recruiter for the ATAHC Study, the largest study of acute HCV in PWID. We showed that treatment of current PWID was successful, even if they continued to inject drugs whilst on therapy
  18. R Guy et al. Does the frequency of HIV and STI testing among MSM in primary care adhere with Australian guidelines? STI, 2010;86: 371-376 (Cit: 46) Senior Author This paper identified low levels of HIV testing in MSM and is informing Australia’s HIV elimination response highlighting the importance of improving access to HIV testing
  19. Hellard et al. Hepatitis C treatment for injecting drug users: a review of the available evidence. Clin Infect Dis 2009; 49:561–7. Cit: 215 This highly cited systematic review was the first study to clearly identify that PWIDs’ response to HCV treatment was equivalent to non-injectors’; it informed national and international HCV guidelines, impacting on clinicians management and increasing PWIDs access to treatment
  20. Aitken et al. (Senior Author) High incidence of hepatitis C virus reinfection in a cohort of injecting drug users. Hepatol 2008; 48:1746-52. Cit: 125 This important paper was one of the first in the world to show that HCV reinfection is common and HCV infection is far more dynamic than previously recognised. The work is informing HCV elimination models and vaccine development
  21. Hellard M et al. A randomized blinded controlled trial investigating the gastrointestinal health effects of drinking water quality. Environ Health Perspectives. 2001; 109:773-778. Cit: 194.

Appointments

  • 2017: Deputy Director (Programs), Burnet Institute
  • 2013: Associate Director, Burnet Institute
  • 2012: Adjunct Professor, Monash University, DEPM.
  • 2011: Head, Hepatitis Services, Infectious Disease Unit, Alfred Hospital, Victoria, Australia
  • 2009: NHMRC Senior Research Fellow
  • 2008: Honorary Senior Fellow, Nossal Institute, University of Melbourne, Victoria, Australia
  • 2006: Honorary Associate Professor, Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
  • 2002-2006: Honorary Senior Lecturer, Department of Epidemiology and Preventive Medicine, Monash University, Australia
  • 2002: Head of the Epidemiology and Social Research Unit (now Centre for Population Health) at Burnet Institute, Melbourne, Victoria, Australia
  • 2001-2009: Infectious Diseases Physician, Royal Melbourne Hospital, Victoria, Australia
  • 2000-2002: Senior Research Fellow, Department of Epidemiology and Preventive Medicine, Monash University, Australia
  • 1996: Infectious Diseases Physician, Alfred Hospital, Melbourne, Australia

Positions

  1. Red Cross Blood Bank Australia – Chair Expert Review Panel on Injecting Drug User Donation Policy
  2. Advisory Committee to Justice Health on Hepatitis C Care and Treatment Victoria
  3. WHO Advisor –Think tank to develop strategies to eliminate hepatitis B and C
  4. WHO Advisor – Hepatitis C Surveillance and Screening
  5. WHO Temporary Advisor - WHO Consultation on Strategic use of ARVs
  6. WHO Temporary Advisor – WHO Consultation on Hepatitis C Modelling
  7. Communicable Diseases Network of Australia National Strategies BBV/STI Subcommittee
  8. InC3 – International Collaboration of Incidence Hepatitis C in Injection Drug users (coordinating committee).
  9. Australian Hepatitis Councils Health Reference Group
  10. Victorian Department of Health Advisory Committee on BBVs and STIs
  11. ASHM Viral Hepatitis Clinical Oversight Committee

Qualifications

  • 2001: FAFPHM, Australasian Faculty of Public Health Medicine
  • 2000: PhD, Department of Epidemiology and Preventive Medicine, Monash University
  • 1996: FRACP, Royal Australasian College of Physicians
  • 1986: MBBS, Monash University

Awards

  • 2019: Member of the Order of Australia (AM) ‘for significant service to medicine as an infectious diseases and public health physician and research scientist’.
  • 2010: Burnet Institute Frank Fenner Award: Recognised for her outstanding leadership, innovation and contribution to the fields of research and public health
  • 2005: Victorian Public Health Award, Program excellence winner for HIV sentinel surveillance
  • 2005: VicHealth Award for Outstanding Achievement in Health Promotions (studies over $75,000) for The epidemiology and control of chlamydia infection in Victoria
  • 2005: VicHealth Award for Outstanding Achievement in Health Promotions (studies less than $15,000) for Uncontested possessions and key positions
  • 2005: Frank Fenner Award for Advanced Research in Infectious Diseases
  • 2004: NHMRC Career Development Award
  • 2004: VicHealth Senior Research Fellowship
  • 2001: Australasian Society of Infectious Diseases, Aztra Zeneca Travel Award
  • 2000: Inaugural Graham Rouch Award, Victorian Branch of the Australasian Faculty of Public Health Medicine
  • 2000: Young Water Scientist of the Year
  • 2000: Victorian Public Health Award for Research Excellence
  • 2000: NHMRC Clinical Research Fellowship
  • 1998: NHMRC Clinical Research Fellowship

Projects (43)

Current (25)

  • ACCESS: STI and BBV surveillance system

  • co-EC Study: Eliminating hepatitis C/HIV coinfection

  • CREIDU: Centre for Research Excellence into Injecting Drug Use

  • CT2 Study: Community-based Testing and Treatment for Hepatitis C

  • DARE C: ATAHC II Substudy

  • EC Partnership: Eliminate Hepatitis C Partnership

  • Eliminate Hepatitis C Australia Partnership: EC Australia

  • Exploring alcohol and other drug use among migrant communities in Victoria

  • HCV Elimination Modelling

  • Healthy Mothers, Healthy Babies

  • Hepatitis C and injecting networks

  • Identifying the structural enablers to the clinical management of people with hepatitis B in general practice: a qualitative investigation

  • Improving Hepatitis B Virus screening in general practice in Victoria

  • Natural history and response to treatment recent hepatitis C virus infection among a cluster of HCV genotype-1b infected individuals

  • Pornography and Young People

  • Responding to COVID-19 and preparing for the future

  • Sex, Drugs, and Rock'n'Roll (Big Day Out Study)

  • SHARP: Screening for Hepatitis in At-Risk Populations

  • Social Networks and the Hepatitis C Virus

  • The Australian Trial in Acute Hepatitis C (ATAHC)

  • The B-VAX Project: Hep B vaccinations for people who inject drugs

  • The International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)

  • TRYP: Transitions and Risk in Young People project

  • Understanding how HCV evades the immune system

  • What drives hepatitis C reinfection?

Past (3)

  • EC Australia: The vital missing link to eliminating hepatitis C

  • Eliminating hepatitis C infection in Victoria through treatment scale up

  • Examining hepatitis C reinfection among HIV co-infected gay and bisexual men

Publications (439)

2020 (29)

2019 (37)

2018 (43)

2017 (34)

2016 (37)

2015 (31)

2014 (30)

2013 (34)

2012 (29)

2011 (22)

2010 (18)

2009 (23)

2008 (19)

2007 (14)

2006 (8)

2005 (5)

2004 (9)

2003 (3)

2002 (1)

2001 (2)

2000 (2)

1998 (3)

1997 (6)

News Articles (97)

2020 (6)

2019 (14)

2018 (14)

2017 (14)

2016 (15)

2015 (9)

2014 (14)

2013 (5)

2012 (4)

2011 (2)