# Molecular characterization of hepatitis B virus genotypes A and D among inmates and blood donors in Northeastern Kenya

## TL;DR

This study examines hepatitis B virus genotypes among prison inmates and blood donors in Kenya, finding genotype D dominance and high recombinant frequency.

## Contribution

First genomic study of HBV in Kenyan prisons, revealing unique genotype D prevalence and high recombination rates.

## Key findings

- Genotype D dominated both prison inmates and blood donors, comprising 81.8% of cases.
- All genotype D strains were recombinants, with D/A and D/E recombinations observed.
- Genotype A subgenotype A1 was found exclusively in incarcerated individuals.

## Abstract

Hepatitis B virus (HBV) persists as a major global public health burden, with hyperendemic prevalence in sub-Saharan Africa. Populations with elevated exposure to percutaneous transmission risks, including incarcerated individuals and healthcare workers demonstrate heightened HBV susceptibility. Despite this, genomic data from Northeastern Kenya and Kenyan prison populations remain scarce.

To characterize HBV genotypic diversity circulating in Northeastern Kenya, among low-risk (blood donors) and high-risk (prison inmates) populations.

A cross-sectional investigation compared HBV seroprevalence and genotypes between incarcerated individuals (n = 130) and voluntary blood donors (n = 130) in Garissa County, Northeastern Kenya. Serum samples were subjected to Hepatitis B surface antigen (HBsAg) screening, PCR amplification of a 940-bp overlapping surface/polymerase gene, sequencing, and phylogenetic/recombination analyses of the resulting sequences.

Seroprevalence was higher among incarcerated individuals (5.4%, 7/130) than blood donors (3.1%, 4/130). Hepatitis B Virus DNA was detected in 22 samples which were all successfully sequenced. Genotype D dominated both cohorts (81.8%), while genotype A sub genotype A1 occurred exclusively in incarcerated participants (18.2%). All genotype D strains were recombinants: D/A (61%) and D/E (39%). Sequences are accessible in GenBank (accession numbers: PV816552–PV816573).

This first genomic study of HBV in Kenyan prisons confirms incarcerated populations as high-risk. The predominance of genotype D—an unusual finding in this region and high recombinant frequency (100% of genotype D strains) underscore significant viral evolution. Expanded genomic surveillance is imperative to define HBV diversity, inform vaccine efficacy monitoring, guide screening policies and optimize control strategies in Northeastern Kenya.