Interim effect evaluation of the hepatitis C elimination programme in Georgia: a modelling study

Area of Science:

• Hepatology and infectious disease research.
• Public health program evaluation.
• Epidemiological modeling and simulation.

Background:

• Georgia faces a high prevalence of hepatitis C virus (HCV) infection.
• A national program was launched in 2015 aiming for HCV elimination by 2020.
• The program focused on scaling up treatment and prevention interventions.

Purpose of the Study:

• To evaluate the interim impact of Georgia's national hepatitis C elimination program.
• To assess the feasibility of achieving the 2020 elimination goal.
• To model the hepatitis C epidemic and project treatment outcomes.

Main Methods:

• A transmission model was developed and calibrated using survey data from people who inject drugs (PWID) and national surveys.
• The model projected the effects of direct-acting antiviral treatments administered through February 2019.
• Incidence, prevalence, and mortality reductions were estimated relative to 2015, alongside averted infections and deaths.

Main Results:

• Between May 2015 and February 2019, over 54,000 patients were treated.
• Current treatment rates project a 51% reduction in prevalence and incidence by end of 2020.
• Achieving the 90% elimination target requires increasing monthly treatment rates to over 4,100 patients.

Conclusions:

• Georgia's HCV program has significantly reduced disease burden through increased treatment.
• The 2020 elimination target is unlikely to be met without a substantial increase in treatment rates.
• Considerable scale-up of treatment initiation is necessary to achieve hepatitis C elimination goals.