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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.
Margaret has over $73 million in competitive research grants and tenders. She was recently awarded an $11.3 million grant from the Paul Ramsay 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.
C Seaman, C Morgan, J Howell, Y Xiao, W Spearman, M Sonderup, O Lesi, M Andersson, M Hellard, N Scott* (equal senior author) Use of the controlled-temperature chain and compact prefilled auto-disable devices to reach 2030 hepatitis B birth dose vaccination targets in low and middle-income countries: A modelling and cost-optimization study. (in press Lancet Global Health) Accepted April 2020
A Pedrana, J Howell, N Scott, S Schroeder, C Kuschel, J Lazarus, R Atun, R Baptista Leite, E t’Hoen, S Hutchinson, L Aufegger, R Peck, A Sohn, T Swan, M Thursz, O Lies, M Sharma, J Thwaites, D Wilson M Hellard. Global hepatitis C elimination: an investment framework. (In press – Lancet Gastro Hepatology) Accepted January 2020
N Scott, C Kuschell, A Pedrana, S Schroeder, J Howell, A Thompson, D Wilson*, M Hellard. A model of the economic benefits of global hepatitis C elimination: an investment case (In press – Lancet Gastro Hepatology) Accepted January 2020
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;212(8):365-70.
A Wade, J Doyle, E Gane, C Stedman, B Draper, D Iser, S Roberts, W Kemp, D Petrie, N Scott, P Higgs, P Agius, J Roney, L Stothers, A Thompson*, M Hellard. Outcomes of treatment for hepatitis C in primary care compared to hospital-based care: a randomised controlled trial in people who inject drugs Clinical Infectious Diseases 2020;70:9:1900-1906
J Howell, H Chan, J Feld, M Hellard, A Thompson. Closing the stable door after the horse has bolted - should we be treating people with immune-tolerant chronic hepatitis B to prevent hepatocellular carcinoma? Gastroenterology Feb 20 2020
A Bowring, F Ampt, S Schwartz, M Stoové, S Luchters, S Baral, M Hellard, Pre-exposure prophylaxis for female sex workers: ensuring women’s family planning needs are not left behind J Int AIDS Soc. Feb 2020;23(2):e25442
CW Spearman, G Dusheiko , M Hellard, Mark Sonderup. The Lancet Seminar: Hepatitis C. Lancet. 2019;394(10207):1451-66
M Traeger, V Cornelisse, J Asselin, B Price, N Roth, J Willcox, BK Tee, CK Fairley, C Chang, J Armishaw, O Vujovic2 M Penn, P Cundill, G Forgan-Smith, John Gall, Claire Pickett, L Lal, Anne Mak, T Spelman, L Nguyen, D Murphy, K Ryan, C El-Hayek, M West, S Ruth, C Batrouney, J Lockwood, J Hoy, M Hellard, M Stoové, E Wright, for the PrEPX Study Team. Association of HIV Pre-exposure Prophylaxis with Incidence of Sexually Transmitted Infections among Individuals at High Risk of HIV Infection JAMA. JAMA. 2019;321(14):1380-1390. doi:10.1001/jama.2019.2947
G Cooke, I Andrieux-Meyer, T Applegate, R Atun, J Burry, H Cheinquer, G Dusheiko, J Feld, C Gore, M Griswold, S Hamid, M Hellard, J LIn Hou, J Howell, J Jia, N Kravchenko, J Lazarus, M Lemoine, O Lesi, L Maistat, B McMahon, H Razavi, T Roberts, B Simmons, M Sonderup, B Taylor, D Thomas, I Waked, J Ward, S Wiktor Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission The Lancet Gastroenterology and Hepatology 2019:4:135-184 http://dx.doi.org/10.1016/S2468-1253(18)