Evidence map›Paper›PMID 40597689›Full record

ArticleBMC infectious diseases2025

Disease progression & treatment need in sub-genotype C4 hepatitis B infection: a retrospective cohort study in the Northern Territory, Australia.

Genevieve E Martin, Kelly Hosking, Kelly Banz, Catherine Gargan, Geoff Stewart, Belinda Greenwood-Smith, Penelope Ramsay, Jaclyn Tate-Baker, Christine Connors, Paula Binks and 19 more

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In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Genevieve E MartinGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Kelly HoskingGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Kelly BanzNorthern Territory Health, Northern Territory, Australia.
Catherine GarganNorthern Territory Health, Northern Territory, Australia.
Geoff StewartNorthern Territory Health, Northern Territory, Australia.
Belinda Greenwood-SmithNorthern Territory Health, Northern Territory, Australia.
Penelope RamsayNorthern Territory Health, Northern Territory, Australia.
Jaclyn Tate-BakerNorthern Territory Health, Northern Territory, Australia.
Christine ConnorsNorthern Territory Health, Northern Territory, Australia.
Paula BinksGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Melita McKinnonGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Prashanti ManchikantiMiwatj Health Aboriginal Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia.
George Garambaka GurruwiwiGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Nicole AllardWHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
Ashleigh QamaWHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
Jessica MichaelsAustralasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Sydney, NSW, Australia.
Emily Vintour-CesarGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Robert BateyNorthern Territory Health, Northern Territory, Australia.
Catherine MarshallGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Peter NihillNorthern Territory Health, Northern Territory, Australia.
Tammy-Allyn FernandesNorthern Territory Health, Northern Territory, Australia.
Karen FullerKatherine West Health Board, Katherine, Northern Territory, Australia.
Steven Y C TongDepartment of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
David BoettigerGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Benjamin CowieDepartment of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
Joshua S DavisGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Sarah Mariyalawuy BukulatjpiMiwatj Health Aboriginal Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia.
Jane DaviesGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. jane.davies@menzies.edu.au.
Hep B PAST Partnership

Funding

National Health and Medical Research Council GNT1151837National Health and Medical Research Council GNT1190918
6 · The paper itself

Abstract

backgroundIn the Northern Territory (NT) of Australia, First Nations people with chronic hepatitis B (CHB) are infected with a unique sub-genotype, C4, which contains mutations linked to progressive fibrosis and hepatocellular carcinoma. This cohort study aimed to investigate disease progression in C4 sub-genotype infection and estimate how many untreated individuals may benefit from antiviral therapy with broadening treatment indications.

methodsIncluded individuals were part of Hep B PAST, a co-designed program to improve the cascade of care for people living with CHB in the NT. Disease phase and cirrhotic status were determined algorithmically using clinical and laboratory data at two time points. Loss of HBV antigens was assessed longitudinally. Treatment need was assessed cross-sectionally in the cohort at study completion. Key outcomes were estimated rates of HBsAg/HBeAg loss in sub-genotype C4 infection and quantification of how many untreated individuals qualify for therapy under current Australian and expanded global treatment guidelines.

resultsHBsAg and HBeAg loss occurred at a rate of 1·04 and 8·06 events/100 person-years respectively (7342·6 and 545·6 years follow up). 783 people living with CHB were included (40% female, median age 48 years). Of these, 16% had cirrhosis (an additional 6% having FibroScan > 7 kPa, meaning 22% had cirrhosis or significant fibrosis) and 25% were prescribed antivirals. Only 6·7% of untreated individuals were treatment eligible under current guidelines. Using the 2024 World Health Organisation guidelines, this increased to 50% due mostly to fibrosis and population prevalence of diabetes.

conclusionsDespite advanced liver disease in people living with CHB in the NT, rates of antigen loss in sub-genotype C4 hepatitis B infection are similar to other genotypes. Further work is needed to understand drivers of cirrhosis and significant fibrosis in this population.

Indexed as

Hepatitis B, ChronicHepatitis B virusAdultAgedAntiviral AgentsCross-Sectional StudiesDisease ProgressionFemaleGenotypeHepatitis B e AntigensHepatitis B Surface AntigensHumansLiver CirrhosisMaleMiddle AgedNorthern TerritoryAntiviral AgentsHepatitis B e AntigensHepatitis B Surface AntigensChronic hepatitis BFirst Nations healthHepatitis B virusLiver cirrhosisViral genotype

Identifiers

PMID40597689
PMCPMC12219930

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