Progress in Testing for and Treatment of Hepatitis C Virus Infection Among Persons Who Inject Drugs — Georgia, 2018

Stvilia, Ketevan; Spradling, Philip R.; Asatiani, Alexander; Gogia, Maka; Kutateladze, Khatuna; Butsashvili, Maia; Zarkua, Jaba; Tsertsvadze, Tengiz; Sharvadze, Lali; Japaridze, Maia; Kuchuloria, Tinatin; Gvinjilia, Lia; Tskhomelidze, Irinka; Gamkrelidze, Amiran; Khonelidze, Irma; Sergeenko, David; Shadaker, Shaun; Averhoff, Francisco; Nasrullah, Muazzam

doi:10.15585/mmwr.mm6829a2

Cited by 19 publications

(23 citation statements)

References 3 publications

(3 reference statements)

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“…Finally, major advances in the development and extensive use of DAAs would be expected to further reduce the prevalence of infection to < 0.001% if prices become affordable. 23 The current rate of high HCV infection in Phetchabun emphasizes the urgent need to initiate a test-to-treat program with pan-genotypic DAAs in Thailand. Unlike the rest of Thailand in which genotype 3a is predominant, the high prevalence of genotype 6 (41%) in Phetchabun affords an opportunity to further evaluate the efficacy of DAAs on this genotype because data from previous efficacy studies have been limited.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Wasitthankasem

Pimsingh

Treesun

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and hepatocellular carcinoma. To eliminate HCV infection in an endemic area, an epidemiological baseline of the current HCV infection in the population is required. We therefore aimed to evaluate the HCV burden in the Thai Province of Phetchabun, which has the highest HCV infection rate in the country. Toward this, a province-wide district-based representative sampling of 4,769 individuals ages 35-64 years previously shown to represent high-risk age-groups were tested for anti-HCV antibodies using the automated chemiluminescent microparticle assays. Active HCV infection and subsequent genotyping were determined from serologically reactive samples by amplification of the HCV core gene. We found that 6.9% (327/4,769) were anti-HCV positive, of which 75.8% (248/327) had detectable HCV RNA and 5.8% (19/327) were in the presence of hepatitis B virus coinfection. Nucleotide sequencing and phylogenetic analysis revealed that HCV genotype 6 was the most prevalent (41%, 101/248), followed by genotype 3 (31%, 78/248), and genotype 1 (28%, 69/248). Socioeconomic and demographic factors including male gender, education, and agricultural work were associated with HCV seropositivity. From these results, we defined the regional HCV genotypes and estimated the HCV burden necessary toward the implementation of pan-genotypic direct-acting antivirals, which may be appropriate and effective toward the diversity of genotypes identified in this study. Micro-elimination of HCV in Phetchabun may serve as a model for a more comprehensive coverage of HCV treatment in Thailand.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Wasitthankasem

Pimsingh

Treesun

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…Alternatively, it is possible that HCV positive participants from Cambodia with undetectable HCV VL had lower antibody titres, as suggested by the fact that proportionally, there were more true positives in samples with undetectable VL from Georgia compared with Cambodia (87.5% versus 50.6% for the HCV-Ab Rapid test and 92.3% vs 63.3% for the First Response HCV card test). Historically, the HCV epidemic in Cambodia has been largely driven through past unsafe medical practices [ 21 , 22 ], whereas Georgia has an ongoing HCV epidemic in injection drug users [ 23 ]. Additionally, one of the two centres in Georgia was an opioid substitution treatment facility, thus a high proportion of Georgian participants would have been injection drug users.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of rapid hepatitis C antibody assays in freshly collected whole blood, plasma and serum samples: A multicentre prospective study

et al. 2020

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Background This study evaluated performance of two hepatitis C virus (HCV) rapid diagnostic tests (RDTs) performed by intended users in resource-limited settings. Methods Testing was conducted at three facilities in two countries (Georgia, Cambodia) using matched fingerstick whole blood, plasma and serum samples. Investigational RDTs were compared with a composite reference standard (CRS) comprised of three laboratory tests, and a reference RDT. Results In matched samples from 489 HCV positive and 967 HCV negative participants, specificity with both investigational RDTs was high using either reference method (≥98.4% in all sample types). Sensitivity was lower in whole blood versus plasma and serum for both RDTs compared with the CRS (86.5–91.4% vs 97.5–98.0% and 97.3–97.1%) and reference RDT (93.6–97.8% vs 100% and 99.4%). Sensitivity improved when considering only samples with detectable HCV viral load. Conclusion Sensitivity was highest in serum and plasma versus whole blood. The World Health Organization prequalification criterion (≥98%) was narrowly missed by both RDTs in serum, and one in plasma, possibly due to the intended user factor. Performance in whole blood was considered adequate, given potential roles of HCV infection history, improved sensitivity with detectable viral load and performance similarities to the reference RDT.

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“…Since 2017, anti-HCV test results among PWIDs who agree to disclose their NIN are recorded in the elimination program database. During 2017-2018, a total of 2780 HR center clients with positive test results for HCV antibody were identi ed in the program database by their NIN (Stvilia et al 2019).…”

Section: Study Populationmentioning

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

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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.

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Progress in Testing for and Treatment of Hepatitis C Virus Infection Among Persons Who Inject Drugs — Georgia, 2018

Cited by 19 publications

References 3 publications

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Sensitivity and specificity of rapid hepatitis C antibody assays in freshly collected whole blood, plasma and serum samples: A multicentre prospective study

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

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