Georgia launches HCV elimination program with help from CDC

In collaboration with the CDC, the country of Georgia launched a hepatitis C virus infection elimination program with the intention of providing and treating people with new curative regimens, providing discounted diagnostics and improving ways for diagnosing and treating the infection in the region, according to a new report.

“Georgia’s government made hepatitis C a health priority,” the researchers wrote. “Georgia engaged partners to develop a comprehensive prevention and control plan in which the concept of setting goals for the elimination of HCV transmission and disease emerged.”

Kiren Mitruka

The Ministry of Labor, Health and Social Affairs (MoLHSA) in Georgia requested assistance from CDC researchers, including Kiren Mitruka, MD, MPH, to develop a plan for HCV prevention and control. The MoLHSA and CDC, along with other national and international partners, conducted workshops that helped prioritize the elements of a successful program. Key priorities identified included the need for a national seroprevalence survey to better identify the burden of HCV infection and improve access to new curative therapies, according to the report.

“The concept of disease elimination in Georgia as an ambitious but viable goal was recognized, given its small size and population, experience with implementation of HIV prevention and control programs, strong political will, and public support,” the researchers wrote. “Georgia committed to conducting the planning and capacity-building needed to implement a comprehensive HCV elimination program.”

Georgia launched the serosurvey in May that collected data through household visits from six cities and 10 rural regions in Georgia. The survey was able to calculate independent HCV prevalence rates, making it easier to determine who had the infection. Next, researchers investigated and assessed four clinical laboratories and eight public health laboratories to determine biosafety, means of communications and reporting, how specimens were collected and more. They found that the laboratories “lacked external quality assurance and quality control procedures” and provider experience for administering medications.

Lastly, the researchers developed a data system that managed clinical, pharmacy, demographic and diagnostic data of patients registered for HCV treatment. Health care providers and the Central Social Service Agency will have access to it to share information, including clinical care.

To secure the new medications, Georgia partnered with Gilead Sciences, which agreed to provide 5,000 courses of Sovaldi (sofosbuvir, Gilead Sciences), followed by 20,000 courses of Harvoni (ledipasvir/sofosbuvir, Gilead Sciences) annually at no cost, according to the report.

Taking all of these elements into consideration, Georgia launched the program in April and early results indicate that from the launch to July 3, a total of 6,491 people presented for treatment and 95.2% of them (n = 6,177) initiated diagnostic work-up, according to the report.

“Georgia is scaling up capacity to meet the demand for HCV treatment, and collaborating with CDC and other partners on development of a comprehensive HCV elimination plan that includes specific goals and activities needed to achieve them,” the researchers wrote.

In addition to the ongoing HCV elimination plan, the MoLHSA is currently working to implement HCV control activities, such as starting a campaign to raise awareness, provide free testing and improving infection-control policies.

“Georgia’s program can serve as model to inform similar efforts in other parts of the world as it develops and implements a comprehensive HCV elimination plan,” the researchers wrote.

Reference:

Mitruka K, et al. The launch of a hepatitis C elimination program in the country of Georgia. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6428a2.htm?s_cid=mm6428a2_w. Accessed July 23, 2015.

Disclosures: The researchers report no relevant financial disclosures.