Whole genome molecular profile of hepatitis B, C and D in Northern-western Tanzania: Identifying gaps for improving current and future management approaches

Viral hepatitis is still a major health concern globally with hepatitis B, hepatitis C, hepatitis B and D co-infection contributing to al-most all of the viral hepatitis burden. In 2022, the World Health Organization (WHO) estimated that 254 million people were living with hepatitis B (PLWHB), 1.2 million people were newly infected by hepatitis B virus (HBV) each year, and 1.1 million hepatitis B related deaths mostly due to liver cirrhosis (LC) and hepatocellular carcinoma (HCC) (1). It also estimated that, about 50 million people were living with hepatitis C (PLWHC), about 1.0 million people were newly infected with hepatitis C virus (HCV) each year, and about 242,000 people died from hepatitis C related diseases mostly LC and HCC(2). Hepatitis D virus (HDV) occurs in co-infection with HBV. HDV/HBV complicates the replication, pathogenesis and clinical outcomes of HBV infection. The defective HDV affects about 12 million PLWHB globally(3). Although, these viral infections are treatable and manageable, they are complicated by their molecular diversity. This pardon for frequent and detailed molecular profiling of these viruses so as to guide prevention, treatment and management. The sub-Sahara Africa including Tanzania have the most burden of these viral infections. Despite this high burden, Tanzania has limited detailed molecular information on these viral infections creating a gap to guide targeted prevention and treatment. As a result, this slows the viral hepatitis elimination efforts in the country. The proposed study aims at closing this gap by conducting a whole genome molecular epidemiology of hepatitis B, C and D among hepatitis B and C mono-infected, and hepatitis B and D coinfected infected individuals attending Bugando Medical Centre (BMC). BMC is a zonal and second biggest referral hospital serving 6-8 regions among the 25 regions of Tanzania. The study will involve pregnant women and chronic hepatitis B and C attending BMC. Whole blood will be drawn from enrolled participants. DNA or RNA extraction and amplification will be performed according to the respective protocol. The amplified nucleic acids will undergo whole genome sequencing by Nanopore technology. The obtained sequences will be genotyped and analyzed for significant clinical variants. Data will be analyzed by STATA version 15. 

1.           (WHO) WHO. July 2025. Hepatitis B.

2.           (WHO) WHO. July 2025. Hepatitis C.

3.           Organization WH. July 2025. Hepatitis D.