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Abstract Details
Hepatitis C Prevalence and Risk Factors in Georgia, 2015: Setting a Baseline for Elimination
BMC Public Health. 2019 May 10;19(Suppl 3):480. doi: 10.1186/s12889-019-6784-3.
Liesl M Hagan1, Ana Kasradze2, Stephanie J Salyer3, Amiran Gamkrelidze2, Maia Alkhazashvili2, Gvantsa Chanturia2, Nazibrola Chitadze2, Roena Sukhiashvili2, Marina Shakhnazarova2, Steven Russell3, Curtis Blanton3, Giorgi Kuchukhidze2, Davit Baliashvili2, Susan Hariri4, Stephen Ko45, Paata Imnadze2, Jan Drobeniuc4, Juliette Morgan36, Francisco Averhoff4
Author information
1Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA. vqf8@cdc.gov.
2National Center for Disease Control and Public Health, Tbilisi, Georgia.
3Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, USA.
4Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA.
5School of Public Health, Boston University, Boston, MA, USA.
6Global Disease Detection - South Caucasus Regional Center, Centers for Disease Control and Prevention, Tbilisi, Georgia.
Free PMC article
Abstract
Background: The country of Georgia launched the world's first Hepatitis C Virus (HCV) Elimination Program in 2015 and set a 90% prevalence reduction goal for 2020. We conducted a nationally representative HCV seroprevalence survey to establish baseline prevalence to measure progress toward elimination over time.
Methods: A cross-sectional seroprevalence survey was conducted in 2015 among adults aged ≥18 years using a stratified, multi-stage cluster design (n = 7000). Questionnaire variables included demographic, medical, and behavioral risk characteristics and HCV-related knowledge. Blood specimens were tested for antibodies to HCV (anti-HCV) and HCV RNA. Frequencies were computed for HCV prevalence, risk factors, and HCV-related knowledge. Associations between anti-HCV status and potential risk factors were calculated using logistic regression.
Results: National anti-HCV seroprevalence in Georgia was 7.7% (95% confidence interval (CI) = 6.7, 8.9); HCV RNA prevalence was 5.4% (95% CI = 4.6, 6.4). Testing anti-HCV+ was significantly associated with male sex, unemployment, urban residence, history of injection drug use (IDU), incarceration, blood transfusion, tattoos, frequent dental cleanings, medical injections, dialysis, and multiple lifetime sexual partners. History of IDU (adjusted odds ratio (AOR) = 21.4, 95% CI = 12.3, 37.4) and blood transfusion (AOR = 4.5, 95% CI = 2.8, 7.2) were independently, significantly associated with testing anti-HCV+ after controlling for sex, age, urban vs. rural residence, and history of incarceration. Among anti-HCV+ participants, 64.0% were unaware of their HCV status, and 46.7% did not report IDU or blood transfusion as a risk factor.
Conclusions: Georgia has a high HCV burden, and a majority of infected persons are unaware of their status. Ensuring a safe blood supply, implementing innovative screening strategies beyond a risk-based approach, and intensifying prevention efforts among persons who inject drugs are necessary steps to reach Georgia's HCV elimination goal.