Wednesday, September 13, 2017

Challenges in HCV Elimination

Challenges in HCV Elimination
JAMA. 2017;318(10):899. doi:10.1001/jama.2017.11457
Early progress in a hepatitis C virus (HCV) elimination program launched 2 years ago in the Eurasian country of Georgia apparently has slowed, leading health officials to focus on improvements in screening and linkage to care.

The Georgia HCV Elimination Program, launched in 2015 with the CDC’s assistance, was the world’s first such countrywide initiative. Its elimination goal was defined as a 90% reduction in HCV prevalence by 2020. The program began with 4 treatment centers, all located in the capital city Tbilisi. By December 2016, 27 centers were operating throughout the country.

From January 2015 to December 2016, nearly 473 000 HCV screening tests were administered. About 11% of patients tested positive and approximately 30 000 were diagnosed with chronic HCV infection. Nearly 20 000 completed treatment; about 5400 were cured.

By the second half of 2016, the average number of people starting treatment each month increased by nearly 300% compared with the previous year. The number initiating treatment peaked at nearly 5000 in September 2016. The following month, however, the numbers began to fall.

Targeted screening programs—at settings such as harm-reduction facilities and prisons that yield a high proportion of positive results—and easier access to treatment are needed if Georgia is to meet its 2020 HCV elimination goal, the authors noted. “Lessons learned from this program can inform similar initiatives in other countries and help curb the global epidemic of viral hepatitis,” they wrote.

News From the Centers for Disease Control and Prevention Section Editor: Rebecca Voelker, MSJ.

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