Aims: 

The BaMBI NT- Babies and Mothers Hep B Investigation aims to identify a cohort of Aboriginal and Torres Strait Islander children born during the era of universal hepatitis B virus (HBV) vaccination at risk of maternal to child transmission of hepatitis B. This study will determine HBV sero-prevalence rates in these children and correlate this with timeliness of receipt of HBV vaccine, receipt of hepatitis B immunoglobulin (HBIg) and maternal viral load. For children who have chronic HBV infection, this study will sequence hepatitis B virus in both mother and child to assess mode of HBV transmission (vertical or horizontal). 

Objectives: 
  • 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
Summary: 

This study is necessary as the vaccine and HBIg are directed at the hepatitis B strain (genotype A2) compared to the circulating NT HBV strain (C4) and thus may not be as effective in the NT.

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 Aboriginal and Torres Strait Islander communities.  

Chief investigators:
Project manager:
Contact information:
Project dates:

The project commenced in 2016 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. Sullivan, R.P., Davies, J., Binks, P, McKinnon, M., Dhurrkay RG., Hosking, K., Bukulatjpi SM., Locarnini, S., Littlejohn, M., Jackson, K., Tong SYV., Davis, JS. Preventing early childhood transmission of hepatitis B in remote Aboriginal communities in northern Australia. Int J Equity Health 21, 186 (2022). https://doi.org/10.1186/s12939-022-01808-z
  3. Hosking, K., Stewart, G., Mobsby, M., Skov, S., Zhao, Y., Su, J-Y. et al. (2020). Data linkage and computerised algorithmic coding to enhance individual clinical care for Aboriginal people living with chronic hepatitis B in the Northern Territory of Australia – Is it feasible? PLoS ONE 15(4): e0232207.
  4. Hla, T., Bukulatjpi, S., Binks, P., Gurruwiwi, G., Dhurrkay, R. & Davies, J. (2020). A “one stop liver shop” approach improves the cascade-of-care for Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in the Northern Territory of Australia: results of a novel care delivery model. International Journal Equity in Health 19:64.
  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. 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
  9. 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
  10. 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.
  11. 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.