HCV elimination program helps identify infection, begin treatment

Georgia’s hepatitis C virus elimination program made significant progress in helping diagnose patients and begin treatment, according to a study published in the Journal of Hepatology.

“Screening programs for hepatitis C began in early 2015 in anticipation of the program launch in April of that year,” Francisco Averhoff, MD, associate from the CDC, and colleagues wrote. “As of December 31, 2018, a total of 1,101,530 adults (39.6% of the Georgian adult population) had been screening with a rapid anti-HCV test at various settings throughout the country.”

Researchers analyzed data from adult patients screened for HCV using recent screening information from Georgia’s HCV elimination program.

Results from the analysis showed that of persons screened, 98,430 (8.9%) had a positive anti-HCV result. After launching the elimination program, the proportion of persons positive for anti-HCV increased to 29.8% in May of 2015. Over time, the percentage decreased, dropping to 2.4% in December of 2018.

Of those screened, 79.7% received HCV RNA or HCV core antigen testing to determine active HCV infection and 85.3% tested positive. From April 2015 to December 2018, 66,916 persons diagnosed with HCV initiated treatment.

Since the program launched in 2015, of the estimated 150,000 persons living with HVC in Georgia, one-third have been identified and received treatments.

Diagnostic testing costs were a significant barrier that the program faced. As a response, the program began lowering costs and simplifying the process and care guidelines.

Still, one of the most significant barriers is patients receiving treatment. To address this issue, the program has increased the number of screening and treatment sites and implemented programs to identify and link HCV infected persons to care.

Georgia offers best practices and lessons learned that can adapt to national elimination plans, specifically to reduce the barrier to HCV identification and linking patients to curative treatment.

“Georgia will encounter new, unforeseen challenges, and must continue to identify and develop innovative approaches to overcoming barriers as the country strives to meet elimination goals,” the researchers wrote. “This country’s robust hepatitis C elimination efforts can serve as a model for countries developing programs not only to eliminate viral hepatitis, but other public health threats as they emerge.” – by Erin T. Welsh

Disclosure: Averhoff reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.