Excellence in viral hepatitis elimination – Lessons from Georgia

Averhoff, Francisco; Lazarus, Jeffrey V.; Sergeenko, David; Colombo, Massimo; Gamkrelidze, Amiran; Tsertsvadze, Tengiz; Butsashvili, Maia; Metreveli, David; Sharvadze, Lali; Hellard, Margaret; Gnes, Stefano; Gabunia, Tamar; Nasrullah, Muazzam

doi:10.1016/j.jhep.2019.06.026

Cited by 21 publications

(31 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All screening, viremia testing and treatment monitoring data are entered into the national elimination program database (7). Access to the database through a unique 11-digit national identification number (NIN) allows for tracking individuals across the whole continuum of care, from screening through treatment and testing for sustained viral response (SVR), i.e.…”

Section: Methodsmentioning

confidence: 99%

“…Despite extensive national screening activities, including among PWID at harm reduction (HR) centers, nearly half of Georgians with HCV infection are not aware of their HCV status. In addition, among those who have screened positive, a significant proportion have not received viremia testing to confirm active HCV infection, and among those with confirmed viremia, a significant proportion have not initiated antiviral treatment (7). PWID bear a disproportionate share of the HCV burden in the country (8) and ensuring access to treatment for this marginalized population is critical for achieving elimination in the country.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Barriers of Linkage to Hepatitis C Care and Treatment among People who Inject Drugs in Georgia

Butsashvili¹,

Abzianidze²,

Kamkamidze³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background People who inject drugs (PWID) in Georgia have a high prevalence of hepatitis C virus antibody (anti-HCV). Access to care among PWID could be prioritized to meet the country’s hepatitis C elimination goals. This study assesses barriers of linkage to hepatitis C care among PWID in Georgia. Methods Study participants were enrolled from 13 harm reduction centers throughout Georgia. Anti-HCV positive PWID who were tested for viremia (linked to care [LC]), were compared to those not tested for viremia within 90 days of screening anti-HCV positive (not linked to care [NLC]). Participants were interviewed about potential barriers to seeking care. Results A total of 500 PWID were enrolled, 245 LC and 255 NLC. LC and NLC were similar with respect to gender, age, employment status, education, knowledge of anti-HCV status, and confidence/trust in the elimination program (p>0.05). More NLC (13.0%) than LC (7.4%) stated they were not sufficiently informed what to do after screening anti-HCV positive (p<0.05). In multivariate analysis, linkage to care was associated with perceived affordability of the elimination program (adjusted prevalence ratio=8.53; 95% confidence interval: 4.14-17.62).ConclusionPost testing counselling and making hepatitis C services affordable could help increase linkage to care among PWID in Georgia.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers of Linkage to Hepatitis C Care and Treatment among People who Inject Drugs in Georgia

Butsashvili¹,

Abzianidze²,

Kamkamidze³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…A coalition between stakeholders is deemed necessary for a successful hepatitis macro-elimination campaign, and Georgia offers a good example of a collaboration between local authorities, academia, pharma and international institutions (Centers for Disease Control, EASL International Liver Foundation). Hepatitis C was diagnosed in 81.6% of all anti-HCV seropositive adults and 92.1% of RNA-positive individuals were linked to care, achieving a cure rate of 98.7% [19].…”

Section: Macro-elimination Strategiesmentioning

confidence: 99%

Elimination of hepatitis C in Europe: can WHO targets be achieved?

Matičič

Lombardi

Mondelli

et al. 2020

Clinical Microbiology and Infection

Self Cite

View full text Add to dashboard Cite

Background: Chronic hepatitis C virus (HCV) infection affects 71 million people worldwide. The availability of highly efficient direct-acting antivirals has revolutionized the treatment landscape with over 95% cure rates. The WHO has launched a global programme to achieve rather ambitious HCV elimination targets for 2030. Objectives: This article aims to provide a critical overview of the current HCV elimination programmes in Europe highlighting the elements that should be implemented to achieve elimination and those that are already in place to promote this process. Sources: Review of the recently published literature and opinion of experts in the field. Content: Elimination of hepatitis C as a public health threat appears to be a difficult task, which should be subdivided into smaller targets, the so-called micro-elimination goals, to increase chances of success. Macro-elimination strategies based on mass-screening are difficult to implement. Evidence supporting the efficacy of micro-elimination comes from key populations, such as people who inject drugs. HCV elimination is proceeding at different speeds in Europe. Some countries are on target with the WHO's objectives whereas others lack economic support and political advocacy, and have insufficient infrastructures to achieve this. The absence of an effective prophylactic vaccine is hampering the process and should be overcome. Implications: Elimination of hepatitis C worldwide appears plausible, but in several countries probably not within the time frame suggested by the WHO. In the absence of vaccination, universal access to HCV treatment would act as a 'therapeutic' option to reduce transmission, especially in high-risk populations.

show abstract

“…As of April 30, 2019, 56,294 patients had initiated hepatitis C treatment within the program, though there has been a gradual decline in the number of people initiating treatment since late 2016 (Averhoff et al, 2019).…”

mentioning

confidence: 99%

“…Despite extensive national screening activities, including among PWID at harm reduction (HR) centers, nearly half of Georgians with HCV infection are not aware of their HCV status (Averhoff et al, 2019). In addition, among those who have screened positive, a signi cant proportion have not received viremia testing to con rm active HCV infection, and among those with con rmed viremia, a signi cant proportion have not initiated antiviral treatment (Averhoff et al, 2019). PWID bear a disproportionate share of the HCV burden in the country (Chikovani et al, 2019) and ensuring access to treatment for this marginalized population is critical for achieving elimination in the country.…”

mentioning

confidence: 99%

Barriers of Linkage to Hepatitis C Care and Treatment Among People Who Inject Drugs in Georgia

Butsashvili

Abzianidze²,

Kamkamidze³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background: People who inject drugs (PWID) in Georgia have a high prevalence of hepatitis C virus antibody (anti-HCV). Access to care among PWID could be prioritized to meet the country’s hepatitis C elimination goals. This study assesses barriers of linkage to hepatitis C care among PWID in Georgia.Methods: Study participants were enrolled from 13 harm reduction centers throughout Georgia. Anti-HCV positive PWID who were tested for viremia (linked to care [LC]), were compared to those not tested for viremia within 90 days of screening anti-HCV positive (not linked to care [NLC]). Participants were interviewed about potential barriers to seeking care.Results: A total of 500 PWID were enrolled, 245 LC and 255 NLC. LC and NLC were similar with respect to gender, age, employment status, education, knowledge of anti-HCV status, and confidence/trust in the elimination program (p>0.05). More NLC (13.0%) than LC (7.4%) stated they were not sufficiently informed what to do after screening anti-HCV positive (p<0.05). In multivariate analysis, linkage to care was associated with perceived affordability of the elimination program (adjusted prevalence ratio=8.53; 95% confidence interval: 4.14-17.62). Conclusions: Post testing counselling and making hepatitis C services affordable could help increase linkage to care among PWID in Georgia.

show abstract

Excellence in viral hepatitis elimination – Lessons from Georgia

Cited by 21 publications

References 9 publications

Barriers of Linkage to Hepatitis C Care and Treatment among People who Inject Drugs in Georgia

Barriers of Linkage to Hepatitis C Care and Treatment among People who Inject Drugs in Georgia

Elimination of hepatitis C in Europe: can WHO targets be achieved?

Barriers of Linkage to Hepatitis C Care and Treatment Among People Who Inject Drugs in Georgia

Contact Info

Product

Resources

About