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. 2020 Aug 22;71(5):1263-1268.
doi: 10.1093/cid/ciz956.

Three Years of Progress Toward Achieving Hepatitis C Elimination in the Country of Georgia, April 2015-March 2018

Tengiz Tsertsvadze  1   2 , Amiran Gamkrelidze  3 , Nikoloz Chkhartishvili  1 , Akaki Abutidze  1 , Lali Sharvadze  2   4 , Vakhtang Kerashvili  1 , Maia Butsashvili  5 , David Metreveli  6 , Lia Gvinjilia  7 , Shaun Shadaker  8 , Muazzam Nasrullah  8 , Ekaterine Adamia  9 , Stefan Zeuzem  10 , Nezam Afdhal  11 , Sanjeev Arora  12 , Karla Thornton  12 , Beth Skaggs  13 , Tinatin Kuchuloria  13 , Maia Lagvilava  9 , David Sergeenko  9 , Francisco Averhoff  8
Affiliations

Three Years of Progress Toward Achieving Hepatitis C Elimination in the Country of Georgia, April 2015-March 2018

Tengiz Tsertsvadze et al. Clin Infect Dis. .

Abstract

Background: In April 2015, in collaboration with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia embarked on the world's first hepatitis C elimination program. We aimed to assess progress toward elimination targets 3 years after the start of the elimination program.

Methods: We constructed a hepatitis C virus (HCV) care cascade for adults in Georgia, based on the estimated 150 000 persons aged ≥18 years with active HCV infection. All patients who were screened or entered the treatment program during April 2015-March 2018 were included in the analysis. Data on the number of persons screened for HCV were extracted from the national HCV screening database. For the treatment component, we utilized data from the Georgia National HCV treatment program database. Available treatment options included sofosbuvir and ledipasvir/sofosbuvir-based regimens.

Results: Since April 2015, a cumulative 974 817 adults were screened for HCV antibodies; 86 624 persons tested positive, of whom 61 925 underwent HCV confirmatory testing. Among the estimated 150 000 adults living with chronic hepatitis C in Georgia, 52 856 (35.1%) were diagnosed, 45 334 (30.2%) initiated treatment with direct-acting antivirals, and 29 090 (19.4%) achieved a sustained virologic response (SVR). Overall, 37 256 persons were eligible for SVR assessment; of these, only 29 620 (79.5%) returned for evaluation. The SVR rate was 98.2% (29 090/29 620) in the per-protocol analysis and 78.1% (29 090/37 256) in the intent-to-treat analysis.

Conclusions: Georgia has made substantial progress in the path toward eliminating hepatitis C. Scaling up of testing and diagnosis, along with effective linkage to treatment services, is needed to achieve the goal of elimination.

Keywords: Georgia; HCV; cascade; elimination.

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Conflict of interest statement

Potential conflicts of interest S. Z. has received honoraria for consultancy and lectures from AbbVie, Gilead, Janssen, Merck Sharp & Dohme, and Intercept. N. A. has received honoraria for consultancies from Merck, Gilead, Echosens, Ligand, and Shionogi. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
HCV care cascade in the country of Georgia, March 2018. Abbreviations: HCV, hepatitis C virus; SVR, sustained virologic response.
Figure 2.
Figure 2.
Hepatitis C virus treatment uptake in the country of Georgia, April 2015–March 2018.
See this image and copyright information in PMC

Comment in

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