It was while working as a clinician in the Northern Territory that Associate Professor Steven Tong, a Royal Melbourne Hospital Clinician Researcher at the Doherty Institute, started to see a lot of Aboriginal patients with chronic hepatitis B virus infection.
In a research collaboration with Professor Stephen Locarnini, a virologist from the Doherty Institute, and the Menzies School of Health Research (Menzies), the team soon discovered that every single Aboriginal person had a specific type of hepatitis B virus called C4, which hasn’t been found anywhere else in the world.
“The virus itself had a different genetic code to other standard hepatitis B viruses,” says Associate Professor Tong.
Now at the Doherty Institute, he continues to work in collaboration with the Menzies on two areas of research.
“We’re following a cohort of Indigenous Australians infected with the hepatitis B C4 virus in a longitudinal study to determine if it causes worse liver disease than other hepatitis B viruses,” he explains.
“We know that Aboriginal people have about six times the rate of liver cancer compared to non-Aboriginal people in the Northern Territory, which is most likely related to high rates of hepatitis B in the Aboriginal population.”
The other, more ambitious project is to eliminate hepatitis B from Aboriginal populations in the Northern Territory.
“We think we have the tools in place to do that – the vaccine is excellent and everyone up to the age of 25 has been vaccinated now,” says Associate Professor Tong.
“For people over 25 who are infected, we’ll aim to get them onto treatment pathways and for those who aren’t infected, we’ll encourage them to be vaccinated.”
As part of a previous project, the Menzies team delivered an iPad application that explained hepatitis B in a local language.
“Now, we want to do that for 10 major languages, as well as work to educate healthcare providers on hepatitis B, moving care from a model where patients have to visit a specialist in Darwin to being looked after by primary healthcare providers in communities.”
Associate Professor Tong and his collaborators also used the hepatitis B virus C4 genome sequences to deduce ancient human population movements into Australia, adding weight to the theory that the mainland Aboriginal population separated from other early humans at least 59 thousand years ago and possibly entered the country near the Tiwi Islands.