Hepatitis C (HCV) treatment history among people who inject drugs (PWID) in Georgia – Integrated Bio-Behavioral Surveillance Survey (IBSS), 2022


Author: Lasha Gulbiani, Maia Butsashvili, Ketevan Stvilia, Tinatin Abzianidze, Maia Kajaia, Sopio Adamia, Tina Kamkamidze, Mariam Pashalishvili, George Kamkamidze

Theme: Epidemiology & Public Health Research Year: 2023

Background:
In April 2015 Georgia launched HCV elimination program providing direct-acting antivirals to all Georgian citizens with chronic HCV infection free of charge. By June 2022 about 55 000 patients had achieved sustained viral response. PWID represent 25% of all HCV cases in the country. We aimed to study HCV treatment history among PWID participating in IBSS 2022 in Georgia.

Methods:
A cross-sectional study was conducted in seven cities of Georgia among PWID. Participants were recruited using respondent-driven sampling. Self-reported HCV treatment history and information from the national HCV treatment database were analyzed to understand the HCV treatment rate among study participants.

Results:
2005 PWID were enrolled. Majority of respondents were >35 years old (n=1570, 78.3%) and male (n=1977, 98.6%). 33.9% (n=680) of participants were treated on HCV. 58.1% (n=1164) of PWID were anti-HCV positive with 32.0% (n=373) HCV RNA positivity. 19.4% (n=149) of individuals who reported being treated for HCV were not actually treated, according to the HCV treatment database. 42.5% (n=437) of people with incarceration history were treated for HCV vs 24.6% (n=232) of those with no incarceration history (OR=0.44; 95% CI:0.36-0.53). Among those having >1 episode of incarceration, HCV treatment rate was higher compared to those having only 1 incarceration history (45.8% vs 37.0%; OR=1.44; 95% CI:1.11-1.86). Spending >1 year in prison during the last episode was associated with HCV treatment experience (48.5% vs 38.8%; p<0.01). By multivariate analysis age (>35) and number of incarcerations (>1) were independent predictors of HCV treatment history.

Conclusion:
Different activities should be implemented to increase enrollment of PWID into the treatment program. The proportion of PWID who reported being treated for HCV infection is much higher compared to percentage of actually treated individuals highlighting the need of HCV educational campaigns to increase the knowledge on HCV antiviral treatment.

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