Prevalence of HCV and genotypes distribution in general population of Georgia.

The aim of four years study was to determine the prevalence of HCV infection in the general population of Georgia and to assess HCV genotypes spread among them. For performing the planned investigation a cross-sectional study design was applied. Study subjects were Tbilisi residents selected through multiple clusters sampling technique application. Tbilisi is divided into ten districts. 2000 persons from the general adult population of Tbilisi, Georgia were enrolled in the study. The multi-stage cluster sampling method was applied for selection of study subjects. Districts of Tbilisi were considered as sub-populations. At the first stage the number of Population distribution by each districts were calculated. Number of study subjects by each districts were determined proportionally population. A list of study participants were obtained from primary sampling units--policlinics (Primary Health Care Units--PHCUs) in all ten districts of Tbilisi. A fieldwork was arranged for interviewing of selected individuals--Approaching the study subjects in households, Face-to-face interview which included signing of the letter of consent by study subject and administering the questionnaires by an interviewer. In totally 2000 persons were investigated and accordingly 2000 blood samples were tested by ELISA for detection of HCV antibodies. 138 out of 2000 (6.9%) samples were found ELISA positive. 138 ELISA positive samples were tested with more specific Recombinant Immunoblot Assay (RIBA) for confirmation. 134 out of 138 (6.7%) of investigated samples were confirmed by RIBA as positives. In this survey, we found that 134 (6.7%) of the 2,000 surveyed individuals were HCV seropositive. According our study, which was based on very strict epidemiological design, we concluded that prevalence of HCV in General population of Georgia is 6.7%. The part of our investigation was to assess HCV genotypes distribution among general population of Georgia. Based on our results the following distributions of HCV genotypes were found: HCV 1b--59%, HCV 3a--27%, HCV 2a/2c--11%, HCV 1a--3%. Our study found high prevalence of HCV among general population of Georgia. Besides, these surveys found an extensive spread of HCV 1b genotype. The profile of HCV genotypes distribution in general population of Georgia was similar to that of USA and Russia and different compared to Asia, Africa and most of European countries. Unfortunately the HCV genotype 1b is less sensitive to current treatment regimens. The treatment effectiveness in patients with HCV genotype 1b is about 45% in comparison to 80% for non-1 genotypes.