Aims:
  • To document the circulating hepatitis B virus (HBV) genotypes in Aboriginal and Torres Strait Islander people across Australia.
  • To describe the management and natural history of HBV in Australian Aboriginal and Torres Strait Islander people.
Objectives:
  • Prospectively recruit patients with HBV infections and correlate the clinical disease picture with infecting HBV genotype.  
  • Determine if vaccine failures are occurring.
Summary:

To date we have recruited over 500 participants with HBV and found all to be infected with a novel HBV genotype.  We continue to follow these participants.  The study has expanded to include Central Australia and communities from remote South Australia, northern Western Australia and Far North Queensland.

Implications for policy and practice:

If vaccine failures are confirmed to have occurred and to be associated with the novel HBV genotype then the vaccine strain used, or the vaccine schedule may need to be changed.  If the disease due to this virus is more aggressive than other HBV genotypes, then earlier screening of patients for liver cancer may be required.

Our research has found: 

A subtype mismatch exists between the current vaccine and the circulating viral genotype in northern Australia. This leads to sub-optimal protection against past hepatitis B virus infection.

We have outlined the HBV genotypes present in the Northern Territory, Far North Queensland, and Western Australia. The predominant genotype in the NT, C4, is associated with more aggressive markers of disease.  We are now investigating the impact of these genotypes and implications for practice.

Chief Investigators:
Project manager:
Contact information:
Project dates:

The project commenced in 2010 and is ongoing. 

Funders:
  • National Health and Medical Research Council
Collaborators:
  • Victorian Infectious Diseases Reference Laboratory.
  1. Hanson, J., Radlof, S., Littlejohn, M., Hempenstall, A., Edwards, R., Nakata, Y., Gregson, S., Hayes, R., Smith, S., McKinnon, M., Binks, P., Tong, S. Y. C., Davies, J., & Davis, J. S. (2023). Hepatitis B genotypes in Aboriginal and Torres Strait Islander Australians: correlation with clinical course and implications for management. Internal Medicine Journal, 10.1111/imj.16181. Advance online publication. https://doi.org/10.1111/imj.16181
  2. Qama, A., Allard, N., Cowie, B., Davis, J. & Davies, J. (2020). Hepatitis B in the Northern Territory: chi into the changing epidemiology of an ancient condition. Internal Medicine Journal, 51:910-922
  3. Davies, J., Smith, E. L., Littlejohn, M., Edwards, R., Sozzi, V., Jackson, K., Mcguire, K., Binks, P., Cowie, B. C., Locarnini, S., Davis, J. S., & Tong, S. Y. C. (2019). Towards Genotype-Specific Care for Chronic Hepatitis B: The First 6 Years Follow Up From the CHARM Cohort Study. Open forum infectious diseases, 6(11), ofz469. https://doi.org/10.1093/ofid/ofz469 
  4. Yuen, L. K. W., Littlejohn, M., Duchêne, S., Edwards, R., Bukulatjpi, S., Binks, P., Jackson, K., Davies, J., Davis, J. S., Tong, S. Y. C., & Locarnini, S. (2019). Tracing Ancient Human Migrations into Sahul Using Hepatitis B Virus Genomes. Molecular biology and evolution, 36(5), 942–954. https://doi.org/10.1093/molbev/msz021
  5. Davies J, Boutlis CS, Marshall CS, Tong SYC, Davis JS. The unique aspects of chronic hepatitis B infection in Aboriginal and Torres Strait Islander people. Internal Medicine Journal 48 (2018) 484-485
  6. Cheah BC, Davies J, Singh GR, Wood N, Jackson K, Littlejohn M, Davison B, McIntyre P, Locarnini S, Davis JS, Tong SYC. Sub-optimal protection against past hepatitis B virus infection where subtype mismatch exists between vaccine and circulating viral genotype in northern Australia. Vaccine 36 (2018) 3533-3540
  7. Davies J, Qin Li S, Tong SYC, Baird RW, Beaman M, Higgins G, Cowie BC, Condon JR, Davis JS. Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population. PLoS ONE 12(9) 2017.
  8. Davies J, Bukulatjpi S, Sharma S, Caldwell L, Johnston V, Davis J. Development of a Culturally Appropriate Bilingual Electronic App About Hepatitis B for Indigenous Australians: Towards Shared Understandings. 2015;4:e70.
  9. Littlejohn M, Davies J, Yuen L, Tong S, Davis JS, Locarnini S. Molecular virology of Hepatitis B virus, subgenotype C4 in Northern Australian Indigenous populations. Journal of Medical Virology 2014; 86: 695-706
  10. Davies J, Bukulatjpi S, Sharma S, Davis J, Johnston V. “Only your blood can tell the story” – a qualitative research study using semi-structured interviews to explore the hepatitis B related knowledge, perceptions and experiences of remote dwelling Indigenous Australians and their health care providers in northern Australia. BMC Public Health 2014, 14:1233
  11. Parker C, Tong SYC, Dempsey K, Condon J, Sharma S, Chen JWC, Sievert W, Davis JS. Hepatocellular carcinoma in Australia’s Northern Territory – high incidence and poor outcomes. Medical Journal of Australia 2014; 201(8): 470-47.
  12. Davies J, Littlejohn M, Locarnini SA, Whiting S, Hajkowicz K, Cowie BC, Bowden DS, Tong SYC, Davis JS.  The molecular epidemiology of hepatitis B in the Indigenous people of northern Australia. Journal of Gastroenterology and Hepatology 2013; 28(7): 1234-1240