Global Viral Hepatitis: Georgia's Hepatitis C Elimination Program

Georgia is among the countries most affected by hepatitis C. As of 2015, about 150,000 Georgians or 5.4% of all adults in the country were living with HCV infection. Most infections are among men between the ages of 30 and 60 years (1). New infections continue to occur, mostly among people who inject drugs (PWID); however, unsafe health practices, like failure to adequately screen all blood donations for hepatitis C and poor infection control in healthcare settings, may still put some Georgians at risk.  In 2015, with technical assistance from CDC, the country embarked on the world’s first national hepatitis C elimination program (2,3), with the following goals to be met by 2020:

  1. a) Identify 90% of HCV-infected persons,
  2. b) Treat 95% of people with chronic HCV infection,
  3. c) Cure 95% of persons treated of their HCV infection, and
  4. d) Reduce the prevalence of HCV by 90%.

This ambitious program provides hepatitis C screening at testing sites throughout the country.

CDC has provided Georgia with technical assistance towards achieving several strategic goals as outlined in the Strategic Plan for the Elimination of Hepatitis C Virus in Georgia, 2016–2020 pdf icon[PDF – 66 pages]external icon. These six strategies include a) promoting advocacy, awareness and education, and partnerships for hepatitis C-associated resource mobilization; b) preventing HCV transmission; c) identifying persons infected with HCV; d) improving hepatitis C laboratory diagnostics; e) providing hepatitis C care and treatment; and f) improving hepatitis C surveillance.

Georgia has implemented various programs and policies, identified challenges and strategies for overcoming barriers, and invested the resources needed to make continued progress towards reaching its elimination goals. As of April 2019, more than 36,000 people living with hepatitis C infection in Georgia had been cured (4). Georgia’s leadership in the field of global viral hepatitis elimination has contributed to it being named the world’s first Center of Excellence in HCV Elimination by the International Liver Foundation, a non-profit organization sponsored by the European Association for the Study of the Liver (4).  Georgia serves as a model for other countries with large numbers of HCV-infected persons. The International Liver Foundation will work with CDC and partners to ensure that the lessons learned in Georgia are documented and used to guide future elimination efforts in other countries.

References

  1. Hagan L, Kasradze A, Salyer S, et al. Hepatitis C prevalence and risk factors in Georgia, 2015: setting a baseline for eliminationexternal icon. BMC Pub Health 2019;19(Suppl 3):480.
  2. Nasrullah M, Sergeenko D, Gvinjilia L, et al. The role of screening and treatment in national progress toward hepatitis C elimination—Georgia, 2015-2016.external icon MMWR 2017;66(29):773–776. [Erratum in: MMWR 2017;Aug 11;66(31):838external icon.]
  3. Mitruka K, Tsertsvadze T, Butsashvili M, et al. Launch of a nationwide hepatitis C elimination program—Georgia, April 2015.external icon MMWR 2015 Jul 24;64(28):753–7. [Erratum in: MMWR 2015;64(29):806.]
  4. Averhoff F, Lazarus JV, Sergeenko D, et al. Excellence in viral hepatitis elimination—lessons from Georgia. J Hepatol 2019; S0168-8278(19)30398–8. [Epub ahead of print.]