Title:
|
The molecular epidemiology and evolution of Hepatitis B virus in the South Pacific
|
Hepatitis B virus (HBV) is of universal concern: currently, around one-third of the global
population (ca. 2 billion people) is, or has been, infected by HBY, it is estimated that
there are 350-400 million chronic carriers and that half a million people die from HBV
associated disease a year. This thesis investigates Hepatitis B Virus evolutionary
dynamics, molecular epidemiology and molecular variants. First, Hepatitis B virus has
presented a considerable challenge for evolutionary rate estimation. Here, this challenge
is re-addressed using a novel analysis of newly acquired serial samples from the
indigenous peoples of the South Pacific, in combination with previously published data.
Second, using probabilistic Bayesian models to estimate evolutionary rates from noncontemporaneous
sequences, as well as, phylogenetic methods for detecting
recombination, the evolutionary history of hepatitis B virus was examined in the
geographical region of Oceania; evolutionary rates, dates of divergence, as well as,
genotype distributions are investigated. Finally, to investigate if Hepatitis B virus is a reemerging
disease in the developing nations of the South Pacific the epidemiological status
in the region was examined in two overlapping surveys. In the first survey the efficacy of
the Hepatitis B virus vaccination programme was examined in three Pacific Island
Countries: Papua New Guinea, the Republic of Fiji Islands and the Republic of Kiribati.
e In the second survey 562 randomly selected human serum samples from Madagascar,
Indonesia and Oceania are screened for naturally occurring surface gene variants of
Hepatitis B virus. A combination of serological and nucleic acid testing techniques are
used to determine both the apparent and hidden, historical as well as contemporary,
incidence of HBV in the region.
|