Tengiz Tsertsvadze1,2, Amiran Gamkrelidze3, Nikoloz Chkhartishvili1, Akaki Abutidze1, Lali Sharvadze2,4, Vakhtang Kerashvili1, Maia Butsashvili5, David Metreveli6, Lia Gvinjilia7, Shaun Shadaker8, Muazzam Nasrullah8, Ekaterine Adamia9, Stefan Zeuzem10, Nezam Afdhal11, Sanjeev Arora12, Karla Thornton12, Beth Skaggs13, Tinatin Kuchuloria13, Maia Lagvilava9, David Sergeenko9, Francisco Averhoff8. 1. Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia. 2. Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia. 3. National Center for Disease Control and Public Health, Tbilisi, Georgia. 4. Hepatology Clinic HEPA, Tbilisi, Georgia. 5. Health Research Union, Tbilisi, Georgia. 6. Medical Center Mrcheveli, Tbilisi, Georgia. 7. Centers for Disease Control and Prevention Foundation, Tbilisi, Georgia. 8. National Center for HIV, Hepatitis, STD, and TB Prevention, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 9. Ministry of Labour, Health and Social Affairs of Georgia, Tbilisi, Georgia. 10. Goethe University Hospital, Frankfurt, Germany. 11. Beth Israel Deaconess Medical Center Liver Center, Boston, Massachusetts, USA. 12. University of New Mexico, Albuquerque, New Mexico, USA. 13. Centers for Disease Control and Prevention South Caucasus Office, Tbilisi, Georgia.
Abstract
BACKGROUND: In April 2015, in collaboration with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia embarked on the world's first hepatitis C elimination program. We aimed to assess progress toward elimination targets 3 years after the start of the elimination program. METHODS: We constructed a hepatitis C virus (HCV) care cascade for adults in Georgia, based on the estimated 150 000 persons aged ≥18 years with active HCV infection. All patients who were screened or entered the treatment program during April 2015-March 2018 were included in the analysis. Data on the number of persons screened for HCV were extracted from the national HCV screening database. For the treatment component, we utilized data from the Georgia National HCV treatment program database. Available treatment options included sofosbuvir and ledipasvir/sofosbuvir-based regimens. RESULTS: Since April 2015, a cumulative 974 817 adults were screened for HCV antibodies; 86 624 persons tested positive, of whom 61 925 underwent HCV confirmatory testing. Among the estimated 150 000 adults living with chronic hepatitis C in Georgia, 52 856 (35.1%) were diagnosed, 45 334 (30.2%) initiated treatment with direct-acting antivirals, and 29 090 (19.4%) achieved a sustained virologic response (SVR). Overall, 37 256 persons were eligible for SVR assessment; of these, only 29 620 (79.5%) returned for evaluation. The SVR rate was 98.2% (29 090/29 620) in the per-protocol analysis and 78.1% (29 090/37 256) in the intent-to-treat analysis. CONCLUSIONS: Georgia has made substantial progress in the path toward eliminating hepatitis C. Scaling up of testing and diagnosis, along with effective linkage to treatment services, is needed to achieve the goal of elimination.
BACKGROUND: In April 2015, in collaboration with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia embarked on the world's first hepatitis C elimination program. We aimed to assess progress toward elimination targets 3 years after the start of the elimination program. METHODS: We constructed a hepatitis C virus (HCV) care cascade for adults in Georgia, based on the estimated 150 000 persons aged ≥18 years with active HCV infection. All patients who were screened or entered the treatment program during April 2015-March 2018 were included in the analysis. Data on the number of persons screened for HCV were extracted from the national HCV screening database. For the treatment component, we utilized data from the Georgia National HCV treatment program database. Available treatment options included sofosbuvir and ledipasvir/sofosbuvir-based regimens. RESULTS: Since April 2015, a cumulative 974 817 adults were screened for HCV antibodies; 86 624 persons tested positive, of whom 61 925 underwent HCV confirmatory testing. Among the estimated 150 000 adults living with chronic hepatitis C in Georgia, 52 856 (35.1%) were diagnosed, 45 334 (30.2%) initiated treatment with direct-acting antivirals, and 29 090 (19.4%) achieved a sustained virologic response (SVR). Overall, 37 256 persons were eligible for SVR assessment; of these, only 29 620 (79.5%) returned for evaluation. The SVR rate was 98.2% (29 090/29 620) in the per-protocol analysis and 78.1% (29 090/37 256) in the intent-to-treat analysis. CONCLUSIONS: Georgia has made substantial progress in the path toward eliminating hepatitis C. Scaling up of testing and diagnosis, along with effective linkage to treatment services, is needed to achieve the goal of elimination.
Authors: Marissa M Maier; David B Ross; Maggie Chartier; Pamela S Belperio; Lisa I Backus Journal: Am J Public Health Date: 2015-11-12 Impact factor: 9.308
Authors: Joseph S Doyle; Nick Scott; Rachel Sacks-Davis; Alisa E Pedrana; Alexander J Thompson; Margaret E Hellard Journal: Aliment Pharmacol Ther Date: 2019-03-25 Impact factor: 8.171
Authors: Ketevan Stvilia; Tengiz Tsertsvadze; Lali Sharvadze; Malvina Aladashvili; Carlos del Rio; Mark H Kuniholm; Kenrad E Nelson Journal: J Urban Health Date: 2006-03 Impact factor: 3.671
Authors: Stefan Zeuzem; Graham R Foster; Stanley Wang; Armen Asatryan; Edward Gane; Jordan J Feld; Tarik Asselah; Marc Bourlière; Peter J Ruane; Heiner Wedemeyer; Stanislas Pol; Robert Flisiak; Fred Poordad; Wan-Long Chuang; Catherine A Stedman; Steven Flamm; Paul Kwo; Gregory J Dore; Gladys Sepulveda-Arzola; Stuart K Roberts; Ruth Soto-Malave; Kelly Kaita; Massimo Puoti; John Vierling; Edward Tam; Hugo E Vargas; Rafi Bruck; Francisco Fuster; Seung-Woon Paik; Franco Felizarta; Jens Kort; Bo Fu; Ran Liu; Teresa I Ng; Tami Pilot-Matias; Chih-Wei Lin; Roger Trinh; Federico J Mensa Journal: N Engl J Med Date: 2018-01-25 Impact factor: 91.245
Authors: Graham S Cooke; Isabelle Andrieux-Meyer; Tanya L Applegate; Rifat Atun; Jessica R Burry; Hugo Cheinquer; Geoff Dusheiko; Jordan J Feld; Charles Gore; Max G Griswold; Saeed Hamid; Margaret E Hellard; JinLin Hou; Jess Howell; Jidong Jia; Natalia Kravchenko; Jeffrey V Lazarus; Maud Lemoine; Olufunmilayo A Lesi; Liudmyla Maistat; Brian J McMahon; Homie Razavi; Teri Roberts; Bryony Simmons; Mark W Sonderup; C Wendy Spearman; Bridie E Taylor; David L Thomas; Imam Waked; John W Ward; Stefan Z Wiktor Journal: Lancet Gastroenterol Hepatol Date: 2019-02
Authors: A Gamkrelidze; S Handanagic; S Shadaker; A Turdziladze; M Tsereteli; V Getia; A Aslanikashvili; S Surguladze; L Gvinjilia; T Kuchuloria; I Tskhomelidze; P A Armstrong Journal: Public Health Date: 2022-02-09 Impact factor: 2.427
Authors: Jake R Morgan; Elizabeth Marsh; Alexandra Savinkina; Sonjelle Shilton; Shaun Shadaker; Tengiz Tsertsvadze; George Kamkamidze; Maia Alkhazashvili; Timothy Morgan; Pam Belperio; Lisa Backus; Waheed Doss; Gamal Esmat; Mohamed Hassany; Aisha Elsharkawy; Wafaa Elakel; Mai Mehrez; Graham R Foster; Constance Wose Kinge; Kara W Chew; Charles S Chasela; Ian M Sanne; Yin M Thanung; Anne Loarec; Khawar Aslam; Suna Balkan; Philippa J Easterbrook; Benjamin P Linas Journal: J Viral Hepat Date: 2022-03-30 Impact factor: 3.517