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. 2023 Jul;28(30):2200837.
doi: 10.2807/1560-7917.ES.2023.28.30.2200837.

Toward reaching hepatitis B goals: hepatitis B epidemiology and the impact of two decades of vaccination, Georgia, 2021

Nino Khetsuriani  1 , Amiran Gamkrelidze  2 , Shaun Shadaker  3 , Maia Tsereteli  2 , Maia Alkhazashvili  2 , Nazibrola Chitadze  2 , Irina Tskhomelidze  4 , Lia Gvinjilia  5 , Francisco Averhoff  6 , Gavin Cloherty  6 , Qian An  1 , Giorgi Chakhunashvili  2 , Jan Drobeniuc  3 , Paata Imnadze  2 , Khatuna Zakhashvili  2 , Paige A Armstrong  3
Affiliations

Toward reaching hepatitis B goals: hepatitis B epidemiology and the impact of two decades of vaccination, Georgia, 2021

Nino Khetsuriani et al. Euro Surveill. 2023 Jul.

Abstract

BackgroundGeorgia has adopted the World Health Organization European Region's and global goals to eliminate viral hepatitis. A nationwide serosurvey among adults in 2015 showed 2.9% prevalence for hepatitis B virus (HBV) surface antigen (HBsAg) and 25.9% for antibodies against HBV core antigen (anti-HBc). HBV infection prevalence among children had previously not been assessed.AimWe aimed to assess HBV infection prevalence among children and update estimates for adults in Georgia.MethodsThis nationwide cross-sectional serosurvey conducted in 2021 among persons aged ≥ 5 years used multi-stage stratified cluster design. Participants aged 5-20 years were eligible for hepatitis B vaccination as infants. Blood samples were tested for anti-HBc and, if positive, for HBsAg. Weighted proportions and 95% confidence intervals (CI) were calculated for both markers.ResultsAmong 5-17 year-olds (n = 1,473), 0.03% (95% CI: 0-0.19) were HBsAg-positive and 0.7% (95% CI: 0.3-1.6) were anti-HBc-positive. Among adults (n = 7,237), 2.7% (95% CI: 2.3-3.4) were HBsAg-positive and 21.7% (95% CI: 20.4-23.2) anti-HBc-positive; HBsAg prevalence was lowest (0.2%; 95% CI: 0.0-1.5) among 18-23-year-olds and highest (8.6%; 95% CI: 6.1-12.1) among 35-39-year-olds.ConclusionsHepatitis B vaccination in Georgia had remarkable impact. In 2021, HBsAg prevalence among children was well below the 0.5% hepatitis B control target of the European Region and met the ≤ 0.1% HBsAg seroprevalence target for elimination of mother-to-child transmission of HBV. Chronic HBV infection remains a problem among adults born before vaccine introduction. Screening, treatment and preventive interventions among adults, and sustained high immunisation coverage among children, can help eliminate hepatitis B in Georgia by 2030.

Keywords: Georgia; Hepatitis B; Hepatitis B vaccine; prevalence; serosurvey.

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Conflict of interest statement

Conflict of interest: Francisco Averhoff and Gavin Cloherty are employed by and own stock in Abbott Diagnostics. No conflicts of interest for other authors.

Figures

Figure 1
Figure 1
WHO-UNICEF estimates of immunisation coverage with at least three doses of hepatitis B-containing vaccines (HepB3) and with hepatitis B vaccine birth dose (HepB-BD), Georgia, 2001–2020
Figure 2
Figure 2
Prevalence of anti-HBc and HBsAg, by region, nationwide serosurvey, Georgia, 2021 (n = 8,710)
Figure 3
Figure 3
Anti-HBc and HBsAg seroprevalence in Georgia, 2015 vs 2021
See this image and copyright information in PMC

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