RT Journal Article SR Electronic(1) A1 Bannister, Elizabeth G. A1 Yuen, Lilly A1 Littlejohn, Margaret A1 Edwards, Rosalind A1 Sozzi, Vitina A1 Colledge, Danni A1 Li, Xin A1 Locarnini, Stephen A1 Hardikar, Winita A1 Revill, Peter AYR 2018 T1 Molecular characterization of hepatitis B virus (HBV) in African children living in Australia identifies genotypes and variants associated with poor clinical outcome JF Journal of General Virology, VO 99 IS 8 SP 1103 OP 1114 DO https://doi.org/10.1099/jgv.0.001086 PB Microbiology Society, SN 1465-2099, AB Migration from sub-Saharan Africa is contributing to the rising incidence of chronic hepatitis B (CHB) infection and its complications in Australia. African CHB is associated with unique genotypes, such as E and A1, which are associated with reduced vaccine efficacy and early-onset hepatocellular carcinoma, respectively, although the prevalence of these genotypes outside Africa is poorly described. Treatment-naïve children of African origin with CHB were recruited at the Royal Children’s Hospital Melbourne. Population-based sequencing of the complete HBV genome, or the clinically relevant basal core promoter (BCP)/precore (PC) region, was performed, and the HBV genotype/subgenotype assigned by phylogenetic analysis. HBV was characterized in serum from 67 children, median age 12.5 years. HBV genotype E was most frequent (70 %), with genotype D [25 %; subgenotypes D6 (formerly D7)/D3/D2)] and subgenotype A1 (5 %) also being identified. Despite their young age, over 50 % of the children were HBeAg-negative and had seroconverted to anti-HBe, with this being associated with canonical BCP/PC mutations in the majority of cases. The profile of HBV in African children living in Australia was characterized by early HBeAg seroconversion and infection with HBV variants associated with poor clinical outcome, as well as genotypes previously associated with reduced vaccine efficacy or rapid progression to liver cancer. These findings have important ramifications for patient monitoring and treatment guidelines in the Australian paediatric setting., UL https://www.microbiologyresearch.org/content/journal/jgv/10.1099/jgv.0.001086