Dataset Information

Interim effect evaluation of the hepatitis C elimination programme in Georgia: a modelling study.

ABSTRACT:

Background

Georgia has a high prevalence of hepatitis C, with 5·4% of adults chronically infected. On April 28, 2015, Georgia launched a national programme to eliminate hepatitis C by 2020 (90% reduction in prevalence) through scaled-up treatment and prevention interventions. We evaluated the interim effect of the programme and feasibility of achieving the elimination goal.

Methods

We developed a transmission model to capture the hepatitis C epidemic in Georgia, calibrated to data from biobehavioural surveys of people who inject drugs (PWID; 1998-2015) and a national survey (2015). We projected the effect of the administration of direct-acting antiviral treatments until Feb 28, 2019, and the effect of continuing current treatment rates until the end of 2020. Effect was estimated in terms of the relative decrease in hepatitis C incidence, prevalence, and mortality relative to 2015 and of the deaths and infections averted compared with a counterfactual of no treatment over the study period. We also estimated treatment rates needed to reach Georgia's elimination target.

Findings

From May 1, 2015, to Feb 28, 2019, 54 313 patients were treated, with approximately 1000 patients treated per month since mid 2017. Compared with 2015, our model projects that these treatments have reduced the prevalence of adult chronic hepatitis C by a median 37% (95% credible interval 30-44), the incidence of chronic hepatitis C by 37% (29-44), and chronic hepatitis C mortality by 14% (3-30) and have prevented 3516 (1842-6250) new infections and averted 252 (134-389) deaths related to chronic hepatitis C. Continuing treatment of 1000 patients per month is predicted to reduce prevalence by 51% (42-61) and incidence by 51% (40-62), by the end of 2020. To reach a 90% reduction by 2020, treatment rates must increase to 4144 (2963-5322) patients initiating treatment per month.

Interpretation

Georgia's hepatitis C elimination programme has achieved substantial treatment scale-up, which has reduced the burden of chronic hepatitis C. However, the country is unlikely to meet its 2020 elimination target unless treatment scales up considerably.

Funding

CDC Foundation, National Institute for Health Research, National Institutes of Health.

SUBMITTER: Walker JG

PROVIDER: S-EPMC7025283 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Interim effect evaluation of the hepatitis C elimination programme in Georgia: a modelling study.

Walker Josephine G JG Kuchuloria Tinatin T Sergeenko David D Fraser Hannah H Lim Aaron G AG Shadaker Shaun S Hagan Liesl L Gamkrelidze Amiran A Kvaratskhelia Valeri V Gvinjilia Lia L Aladashvili Malvina M Asatiani Alexander A Baliashvili Davit D Butsashvili Maia M Chikovani Ivdity I Khonelidze Irma I Kirtadze Irma I Kuniholm Mark H MH Otiashvili David D Sharvadze Lali L Stvilia Ketevan K Tsertsvadze Tengiz T Zakalashvili Mamuka M Hickman Matthew M Martin Natasha K NK Morgan Juliette J Nasrullah Muazzam M Averhoff Francisco F Vickerman Peter P

The Lancet. Global health 20191218 2

<h4>Background</h4>Georgia has a high prevalence of hepatitis C, with 5·4% of adults chronically infected. On April 28, 2015, Georgia launched a national programme to eliminate hepatitis C by 2020 (90% reduction in prevalence) through scaled-up treatment and prevention interventions. We evaluated the interim effect of the programme and feasibility of achieving the elimination goal.<h4>Methods</h4>We developed a transmission model to capture the hepatitis C epidemic in Georgia, calibrated to data ...[more]

PMID: 31864917

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Dataset Information

Interim effect evaluation of the hepatitis C elimination programme in Georgia: a modelling study.

Background

Methods

Findings

Interpretation

Funding

Publications

Interim effect evaluation of the hepatitis C elimination programme in Georgia: a modelling study.

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