The BaMBI NT- Babies and Mothers hep B Investigation aims to identify a cohort of Indigenous children born during the era of universal HBV vaccination, and at risk of maternal to child transmission of hepatitis B and determine HBV sero-prevalence rates in these children and correlate this with timeliness of receipt of HBV vaccine and HBIg and maternal viral load.
For most children who have chronic HBV infection, determine if HBV was most likely acquired through vertical transmission or horizontal transmission (through sequencing of the Hepatitis B virus in both mother and child)
- Identify children born to HBsAg +ve women in the Top End from 1988-2013
- Determine the level of follow up management received since birth, in line with the recommendation in NT HBV guidelines.
- Facilitate the identification of and clinical assessment of children with chronic HBV infection as per the NT and national guidelines
This study is particularly required as the vaccine and HBIg are directed at a different Hepatitis B strain (genotype A2) compared to the circulating HBV strain (C4) and thus may not be as effective as seen elsewhere.
Implications for policy and practice:
By better understanding the risk of Mother to child transmission (MTCT) of HBV and the effectiveness of the vaccine in our setting, we can better inform vaccine policy and efforts to prevent MTCT. This project will provide data around the relative contribution of perinatal transmission vs. early childhood horizontal transmission in remote indigenous communities.
The project commenced in 2016 and is ongoing.
- National Health and Medical Research Council
- Victorian Infectious Diseases Reference Laboratory.
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
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
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.
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.
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
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
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.
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): 1234-1241.