HCV elimination efforts in Georgia lower infections by 61%, may advance reaching 2030 goal
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Key takeaways:
- Georgia’s HCV elimination program decreased infections by 61% in the general population and 55% among persons who inject drugs.
- Of those estimated to have HCV, 82.8% received a positive diagnosis.
A hepatitis C elimination program in Georgia reduced the estimated annual incidence of new infections by 61% since its launch in April 2015, which may accelerate efforts to reach the global 2030 elimination goal.
“Georgia, a country in the Caucasus region, had a prevalence of chronic HCV infection of 5.4% in 2015, compared with a global average of 1%,” Rania A. Tohme, MD, MPH, the CDC’s associate director for global health in the division of viral hepatitis, and colleagues wrote in the Morbidity and Mortality Weekly Report. “In April 2015, in collaboration with CDC and other partners, Georgia launched the world’s first hepatitis C elimination program.”
They continued: “In April 2024, Georgia’s government endorsed a hepatitis B elimination program.”
Using published nationwide serologic surveys, Tohme and colleagues complied data on chronic HBV and HCV seroprevalence and used modeled estimates to determine the incidence of new infections. The researchers also used data from the national HCV screening and treatment registries to calculate the number of people who received testing and treatment, as well as vital registry data to estimate combined HBV and HCV mortality.
According to serologic survey data from 2021, chronic HCV prevalence was 1.8% (95% CI, 1.3-2.4) — a 67% decrease in disease prevalence from 2015. The survey also found that hepatitis B surface antigen seroprevalence was 0.03% among children and adolescents aged 5 to 17 years and 2.7% in the adult population.
“Sustained hepatitis B vaccination coverage above 90% has substantially reduced prevalence of infection in children; however, prevalence in adults remains high,” the researchers wrote, citing consistently high birth-dose and infant vaccination coverage from 2015 to 2023.
Modeled analyses from the 2021 survey demonstrated a reduction in the estimated annual incidence of new chronic HCV infection from 132 to 52 per 100,000 in the general population and 2.51 to 1.14 per 100 persons who inject drugs (PWID). However, the combined HBV and HCV mortality increased from 2015 to 2023 (6.3 per 100,000 persons vs. 7.8 per 100,000 persons).
Of 2.8 million adults in Georgia, 89.3% underwent HCV antibody screening by April 2024, and of 130,000 people estimated to have current chronic HCV, 82.8% received a positive diagnosis. Among those eligible for treatment, 86.1% initiated and 94.8% completed treatment, with a cure rate of 99%.
“Since launching its hepatitis C elimination program in April 2015, Georgia has made substantial progress in diagnosing and treating persons with HCV infection, improving the safety of the blood supply and scaling up prevention services, leading to a 61% decrease in the estimated annual incidence of new chronic HCV infections among the general population and a 55% decline among PWID,” Tohme and colleagues wrote. “Scaling up hepatitis B screening and treating those who are eligible for treatment would decrease hepatitis B-associated morbidity and mortality and expedite progress toward elimination by 2030.”
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