Modelling and economic evaluation of Hepatitis B virus elimination in Georgia

A 2015 national serosurvey in Georgia estimated chronic HCV prevalence at 5.4% and chronic HBV infection at 2.9%. In response, the country launched an HCV elimination program, achieving a 67% reduction in chronic HCV prevalence by 2021, while HBV prevalence remained at 2.7%. The study also found that infant vaccination, introduced in 2001, had effectively controlled HBV in children. To meet the WHO’s 2030 elimination targets, Georgia is now prioritizing the scale-up of HBV treatment. Previous modeling work at the University of Bristol supported HCV policy decisions, and similar HBV modeling will aid resource allocation and elimination strategies.

This PhD project aims to develop and parameterize an HBV transmission model for Georgia to identify cost-effective elimination strategies. The objectives are to:
- Develop and calibrate an HBV transmission model reflecting the epidemic in Georgia, including key risk groups.
- Simulate intervention scenarios (e.g., case-finding strategies) and evaluate their impact on HBV incidence and mortality to assess progress toward WHO elimination targets.
- Estimate costs and cost-effectiveness of elimination strategies, incorporating distributional cost-effectiveness analysis to address equity.

This project will use compartmental deterministic modeling with ordinary differential equations, parameterized and calibrated using Bayesian methods. A tailored HBV transmission model will be developed to incorporate key transmission modes, optimize data use, and address policy-relevant questions. Coding will be conducted in R and/or MATLAB, leveraging high-performance computing. Data sources include epidemiological data, treatment rates, health-related quality of life measures, and intervention costs, with cost data collection in Georgia informing intervention estimates. Regular stakeholder engagement will ensure that the model informs policy decisions.

Supervisors
Dr. Josephine Walker, Dr. Anna McNaughton, Prof. Peter Vickerman.