Intra-host genetic diversity of Hepatitis B virus among mother-infant pairs in Botswana

Perinatal transmission is a major route of hepatitis B virus (HBV) transmission in countries with high prevalence rates. 80-90% of HBV infections acquired in the first year of life result in a chronic infection. HBV e antigen positivity and/or HBV viral loads, increases risk of perinatal transmission.

HBV vaccination has reduced HBV incidence in infants in some parts of the world. However, the African region has the highest HBV incidence of 2.34% in children under 5-years of age.

The World Health Organization plans to eliminate HBV by 2030, by decreasing the HBV prevalence to less than 0.1% in children who are 5-years of age.

This project aims to investigate viral transmission dynamics and intra-host evolution of HBV in mother-infant pairs in Botswana. We will screen for HBV infections in 450 mother-infant pairs from a previous study conducted in 2016–2021.

We will further determine HBV diversity in the HBV positive mother-infant pairs using next generation sequencing and novel bioinformatics pipelines.

This study will enhance understanding of HBV evolution and inform development of vaccines which are effective against vaccine escape mutations and including routine HBV screening as part of antenatal care. Understanding HBV evolution gives insights in virus-host interactions.