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- 1Population Health Sciences, University of Bristol, Bristol, United Kingdom [1]
- 2Task Force for Global Health, Tbilisi, Georgia [1]
- 3Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, United States [1]
- 4National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia [1]
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Between May 2015 and February 2022 77168 hepatitis C virus (HCV)-infected people in Georgia have been treated through an HCV elimination programme. To project the programme’s long-term impacts an HCV infection model was initially developed based on data from surveys among people who inject drugs and a national serosurvey in 2015.
Accounting for follow-up surveys in 2021 we validate and update projections of HCV infection prevalence and incidence.
We assessed the initial model projections’ accuracy for overall prevalence by age sex and among people who ever injected drugs compared with 2021 serosurvey data. We used 2021 results to weight model fits and to recalculate the national programme’s impact leading up to March 2022 on HCV infection incidence rates. Cases and deaths averted were estimated. The impact of reduced treatment rates during the COVID-19 pandemic was assessed.
The original model overpredicted adult (≥ 18 years old) chronic HCV infection prevalence for 2021 (2.7%; 95% credible interval (CrI): 1.9–3.5%) compared with a 2021 serosurvey (1.8%; 95% confidence interval (CI): 1.3–2.4%). Weighted model projections estimated a 60% decrease in HCV infection incidence by March 2022 with an absolute incidence of 66 (95% CrI: 34–131) per 100000 person-years (overall population). Between May 2015 and March 2022 9186 (95% CrI: 5396–16720) infections and 842 (95% CrI: 489–1324) deaths were averted. The COVID-19 pandemic resulted in 13344 (95% CrI: 13236–13437) fewer treatments and 438 (95% CrI: 223-744) fewer averted infections by March 2022.
Results support the programme’s high effectiveness. At current treatment rate (406/month) 90% reductions in prevalence and incidence in Georgia are achievable by 2030.