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Abstract Details
An Evaluation of the Hepatitis C Testing, Care and Treatment Program in the Country of Georgia's Corrections System, December 2013 - April 2015
BMC Public Health. 2019 May 10;19(Suppl 3):466. doi: 10.1186/s12889-019-6783-4.
1Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA, 30329, USA. amharris@cdc.gov.
2Infectious diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
3Hubert Fellowship, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
4Ministry of Corrections, Tbilisi, Georgia.
5Global Disease Detection, Division of Global Health Protection, Centers for Disease Control and Prevention, Tbilisi, Georgia.
6National Center for Disease Control and Public Health of Georgia, Ministry of Labour Health and Social Affairs (MoLHSA) of Georgia, Tbilisi, Georgia.
7Ministry of Internal Affairs, Tbilisi, Georgia.
8Treatment access activist, Tbilisi, Georgia.
9Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA, 30329, USA.
10Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
11Health Research Union / Clinic Neolab, Tbilisi, Georgia.
12Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Free PMC article
Abstract
Background: The country of Georgia has a high burden of chronic hepatitis C virus (HCV) infection, and prisoners are disproportionately affected. During 2013, a novel program offering no cost screening and treatment of HCV infection for eligible prisoners was launched.
Methods: The HCV treatment program implemented a voluntary opt-in anti-HCV testing policy to all prisoners. Anti-HCV positive persons received HCV RNA and genotype testing. Transient elastography was also performed on prisoners with positive HCV RNA results. Prisoners with chronic HCV infection who had ≥F2 Metavir stage for liver fibrosis and a prison sentence ≥ 6 months were eligible for interferon-based treatment, which was the standard treatment prior to 2015. We conducted an evaluation of the HCV treatment program among prisoners from the program's inception in December 2013 through April 2015 by combining data from personal interviews with corrections staff, prisoner data in the corrections database, and HCV-specific laboratory information.
Results: Of an estimated 30,000 prisoners who were incarcerated at some time during the evaluation period, an estimated 13,500 (45%) received anti-HCV screening, of whom 5175 (38%) tested positive. Of these, 3840 (74%) received HCV RNA testing, 2730 (71%) tested positive, and 880 (32%) met treatment eligibility. Of these, 585 (66%) enrolled; 405 (69%) completed treatment, and 202 (50%) achieved a sustained virologic response at least 12 weeks after treatment completion.
Conclusions: HCV infection prevalence among Georgian prisoners was high. Despite challenges, we determined HCV treatment within Georgian Ministry of Correction facilities was feasible. Efforts to address HCV infection among prison population is one important component of HCV elimination in Georgia.