Impact of Hepatitis C Virus (HCV) Infection and Treatment on Mortality in the Country of Georgia, 2015–2020

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Gvinjilia, Lia ; Baliashvili, Davit ; Shadaker, Shaun ; Averhoff, Francisco ; Kandelaki, Levan ; Kereselidze, Maia ; Tsertsvadze, Tengiz ; Chkhartishvili, Nikoloz ; Butsashvili, Maia ; Metreveli, David ; Gamkrelidze, Amiran ; Armstrong, Paige A.
• Description:
  Background.
  
  Mortality related to hepatitis C virus (HCV) infection is a key indicator for elimination. We assessed the impact of HCV infection and treatment on mortality in the country of Georgia during 2015–2020.
  
  Methods.
  
  We conducted a population-based cohort study using data from Georgia’s national HCV Elimination Program and death registry. We calculated all-cause mortality rates in 6 cohorts: (1) Negative for anti-HCV; (2) anti-HCV positive, unknown viremia status; (3) current HCV infection and untreated; (4) discontinued treatment; (5) completed treatment, no sustained virologic response (SVR) assessment; (6) completed treatment and achieved SVR. Cox proportional hazards models were used to calculate adjusted hazards ratios and confidence intervals. We calculated the cause-specific mortality rates attributable to liver-related causes.
  
  Results.
  
  After a median follow-up of 743 days, 100 371 (5.7%) of 1 764 324 study participants died. The highest mortality rate was observed among HCV infected patients who discontinued treatment (10.62 deaths per 100 PY, 95% confidence interval [CI]: 9.65, 11.68), and untreated group (10.33 deaths per 100 PY, 95% CI: 9.96, 10.71). In adjusted Cox proportional hazards model, the untreated group had almost 6-times higher hazard of death compared to treated groups with or without documented SVR (adjusted hazard ratio [aHR] = 5.56, 95% CI: 4.89, 6.31). Those who achieved SVR had consistently lower liver-related mortality compared to cohorts with current or past exposure to HCV.
  
  Conclusions.
  
  This large population-based cohort study demonstrated the marked beneficial association between hepatitis C treatment and mortality. The high mortality rates observed among HCV infected and untreated persons highlights the need to prioritize linkage to care and treatment to achieve elimination goals.
  
  
• Subjects:
  Antiviral Agents Cohort Studies Georgia Hepacivirus Hepatitis C Hepatitis C, Chronic Humans
• Source:
  Clin Infect Dis. 77(3):405-413
• Pubmed ID:
  37099136
• Pubmed Central ID:
  PMC10527899
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  77
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:3df56306967fcdaf4355f52839733bff5dd36823f5acdeb7a910627df399e3a177d3b0561192925b5bd4d266779ecad8fd76a0f535dad9f204f03c55dfbb4934
• Download URL:
  https://stacks.cdc.gov/view/cdc/133509/cdc_133509_DS1.pdf
• File Type:
  [PDF - 393.13 KB ]