Insights from a national survey in 2021 and from modelling on progress towards hepatitis C virus elimination in the country of Georgia since 2015

Josephine G Walker*, Irina Tskhomelidze, Shaun Shadaker, Maia Tsereteli, Senad Handanagic, Paige A Armstrong, Amiran Gamkrelidze, Peter T Vickerman

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

Background
Between May 2015 and February 2022, 77,168 hepatitis C virus (HCV)-infected people in Georgia have been treated through an HCV elimination programme. To project the programme’s long-term impacts, an HCV infection model was initially developed, based on data from surveys among people who inject drugs and a national serosurvey in 2015.

Aim
Accounting for follow-up surveys in 2021, we validate and update projections of HCV infection prevalence and incidence.

Method
We assessed the initial model projections’ accuracy for overall prevalence, by age, sex, and among people who ever injected drugs, compared with 2021 serosurvey data. We used 2021 results to weight model fits and to recalculate the national programme’s impact leading up to March 2022 on HCV infection incidence rates. Cases and deaths averted were estimated. The impact of reduced treatment rates during the COVID-19 pandemic was assessed.

Results
The original model overpredicted adult (≥ 18 years old) chronic HCV infection prevalence for 2021 (2.7%; 95% credible interval (CrI): 1.9–3.5%) compared with a 2021 serosurvey (1.8%; 95% confidence interval (CI): 1.3–2.4%). Weighted model projections estimated a 60% decrease in HCV infection incidence by March 2022, with an absolute incidence of 66 (95% CrI: 34–131) per 100,000 person-years (overall population). Between May 2015 and March 2022, 9,186 (95% CrI: 5,396–16,720) infections and 842 (95% CrI: 489–1,324) deaths were averted. The COVID-19 pandemic resulted in 13,344 (95% CrI: 13,236–13,437) fewer treatments and 438 (95% CrI: 223-744) fewer averted infections by March 2022.

Conclusion
Results support the programme’s high effectiveness. At current treatment rate (406/month), 90% reductions in prevalence and incidence in Georgia are achievable by 2030.
Original languageEnglish
Number of pages10
JournalEurosurveillance
Volume28
Issue number30
DOIs
Publication statusPublished - 27 Jul 2023

Bibliographical note

Funding Information:
JGW and PV have received an investigator sponsored research grant from Gilead Sciences, which funded this work. The funder played no role in the design of the study, the analysis or interpretation of the data, or the decision to publish.

Publisher Copyright:
© 2023 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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