Abstract
BackgroundThe country of Georgia launched the world’s first Hepatitis C Virus (HCV) Elimination Program in 2015 and set a 90% prevalence reduction goal for 2020. We conducted a nationally representative HCV seroprevalence survey to establish baseline prevalence to measure progress toward elimination over time.MethodsA cross-sectional seroprevalence survey was conducted in 2015 among adults aged ≥18 years using a stratified, multi-stage cluster design (n = 7000). Questionnaire variables included demographic, medical, and behavioral risk characteristics and HCV-related knowledge. Blood specimens were tested for antibodies to HCV (anti-HCV) and HCV RNA. Frequencies were computed for HCV prevalence, risk factors, and HCV-related knowledge. Associations between anti-HCV status and potential risk factors were calculated using logistic regression.ResultsNational anti-HCV seroprevalence in Georgia was 7.7% (95% confidence interval (CI) = 6.7, 8.9); HCV RNA prevalence was 5.4% (95% CI = 4.6, 6.4). Testing anti-HCV+ was significantly associated with male sex, unemployment, urban residence, history of injection drug use (IDU), incarceration, blood transfusion, tattoos, frequent dental cleanings, medical injections, dialysis, and multiple lifetime sexual partners. History of IDU (adjusted odds ratio (AOR) = 21.4, 95% CI = 12.3, 37.4) and blood transfusion (AOR = 4.5, 95% CI = 2.8, 7.2) were independently, significantly associated with testing anti-HCV+ after controlling for sex, age, urban vs. rural residence, and history of incarceration. Among anti-HCV+ participants, 64.0% were unaware of their HCV status, and 46.7% did not report IDU or blood transfusion as a risk factor.ConclusionsGeorgia has a high HCV burden, and a majority of infected persons are unaware of their status. Ensuring a safe blood supply, implementing innovative screening strategies beyond a risk-based approach, and intensifying prevention efforts among persons who inject drugs are necessary steps to reach Georgia’s HCV elimination goal.
Highlights
The country of Georgia launched the world’s first Hepatitis C Virus (HCV) Elimination Program in 2015 and set a 90% prevalence reduction goal for 2020
A 2002 survey in the capital city of Tbilisi found that 6.7% of the general population and 70.4% of persons who inject drugs had antibodies to HCV [9], suggesting that HCV prevalence in Georgia could be among the highest globally
This paper presents the results of the first nationally representative HCV seroprevalence survey in Georgia, conducted in 2015 by Georgia’s National Center for Disease Control and Public Health (NCDC) in collaboration with the United States Centers for Disease Control and Prevention (CDC)
Summary
The country of Georgia launched the world’s first Hepatitis C Virus (HCV) Elimination Program in 2015 and set a 90% prevalence reduction goal for 2020. We conducted a nationally representative HCV seroprevalence survey to establish baseline prevalence to measure progress toward elimination over time. There are an estimated 71 million people living with hepatitis C virus (HCV) infection and 411,000 HCV-attributable deaths annually [1]. In 2015, Georgia launched the world’s first HCV elimination program, aiming to provide universal access to curative, direct-acting antiviral (DAA) treatment at no cost to patients, and to implement nationwide prevention measures to curb transmission [10]. Data documenting updated nationwide HCV prevalence and risk factors for infection are necessary to effectively plan treatment and prevention services supporting Georgia’s HCV elimination goals, and to establish a baseline to track progress toward elimination over time
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