Evidence map›Paper›PMID 31864917›Full record

ArticleThe Lancet. Global health2020

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

Josephine G Walker, Tinatin Kuchuloria, David Sergeenko, Hannah Fraser, Aaron G Lim, Shaun Shadaker, Liesl Hagan, Amiran Gamkrelidze, Valeri Kvaratskhelia, Lia Gvinjilia and 19 more

Open access · goldAbstract read
In one paragraph

Article in The Lancet. Global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 27 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Cost-Effectiveness of Hepatitis C Virus Case Finding and Treatment in Eastern Europe and Central Asia.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
  5. Article
  6. [The status of national and global hepatitis C elimination].Innere Medizin (Heidelberg, Germany) · 2024
    Review
  7. Insights from a national survey in 2021 and from modelling on progress towards hepatitis C virus elimination in the country of Georgia since 2015.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023
    Article
  8. Article
  9. Economic evaluation of the Hepatitis C virus elimination program in the country of Georgia, 2015 to 2017.Liver international : official journal of the International Association for the Study of the Liver · 2023
    Article
  10. Article
  11. Article
  12. Review
  13. Barriers of linkage to HCV viremia testing among people who inject drugs in Georgia.Substance abuse treatment, prevention, and policy · 2022
    Article
  14. Article
  15. Hepatitis C virus micro-elimination: Where do we stand?World journal of gastroenterology · 2021
    Review
  16. Article
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors at 12 institutions in 3 countries.

Josephine G WalkerPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: j.g.walker@bristol.ac.uk.
Tinatin KuchuloriaCenters for Disease Control and Prevention Foundation, Tbilisi, Georgia; TEPHINET, Tbilisi, Georgia.
David SergeenkoMinistry of Labor Health and Social Affairs of Georgia, Tbilisi, Georgia.
Hannah FraserPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Aaron G LimPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Shaun ShadakerDivision of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Liesl HaganDivision of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Amiran GamkrelidzeNational Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
Valeri KvaratskheliaMinistry of Labor Health and Social Affairs of Georgia, Tbilisi, Georgia.
Lia GvinjiliaCenters for Disease Control and Prevention Foundation, Tbilisi, Georgia; TEPHINET, Tbilisi, Georgia.
Malvina AladashviliInfectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
Alexander AsatianiNational Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
Davit BaliashviliNational Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Maia ButsashviliNeolab, Tbilisi, Georgia.
Ivdity ChikovaniCuratio International Foundation, Tbilisi, Georgia.
Irma KhonelidzeNational Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
Irma KirtadzeAddiction Research Center Alternative Georgia, Tbilisi, Georgia; Ilia State University, Faculty of Arts and Sciences, Institute of Addiction Studies, Tbilisi, Georgia.
Mark H KuniholmDepartment of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA.
David OtiashviliAddiction Research Center Alternative Georgia, Tbilisi, Georgia.
Lali SharvadzeHEPA Clinic, Tbilisi, Georgia.
Ketevan StviliaNational Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
Tengiz TsertsvadzeInfectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
Mamuka ZakalashviliMedical Center Mrcheveli, Tbilisi, Georgia.
Matthew HickmanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Natasha K MartinPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Division of Infectious Diseases and Global Public Health, UC San Diego, California, USA.
Juliette MorganDivision of Global Health Protection, South Caucasus Centers for Disease Control and Prevention Office, Tbilisi, Georgia.
Muazzam NasrullahDivision of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Francisco AverhoffDivision of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Peter VickermanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
University of Bristol · GBCenters for Disease Control and Prevention · USNational Center for Disease Control and Public Health · GEAIDS and Clinical Immunology Research Center · GEMinistry of Labour, Health and Social Affairs · GECuratio International Foundation · GEEmory University · USIlia State University · GENational Center for HIV/AIDS Viral Hepatitis STD and TB Prevention · USNeoGenomics (United States) · USTraining Programs in Epidemiology and Public Health Interventions Network · USUniversity at Albany, State University of New York · US

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Maile Ann Young Karris · 1994 to 2026
$78.4M
Emory-Georgia TB Research Training ProgramD43TW007124 · FIC · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Nestani Tukvadze · 2004 to 2026
$4.6M
Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modelingR01AI147490 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA · 2019 to 2022
$2.3M
FIC NIH HHS D43 TW007124NCATS NIH HHS UL1 TR001442NIAID NIH HHS P30 AI036214NIAID NIH HHS R01 AI147490
6 · The paper itself

Abstract

backgroundGeorgia has a high prevalence of hepatitis C, with 5·4% of adults chronically infected. On April 28, 2015, Georgia launched a national programme to eliminate hepatitis C by 2020 (90% reduction in prevalence) through scaled-up treatment and prevention interventions. We evaluated the interim effect of the programme and feasibility of achieving the elimination goal.

methodsWe developed a transmission model to capture the hepatitis C epidemic in Georgia, calibrated to data from biobehavioural surveys of people who inject drugs (PWID; 1998-2015) and a national survey (2015). We projected the effect of the administration of direct-acting antiviral treatments until Feb 28, 2019, and the effect of continuing current treatment rates until the end of 2020. Effect was estimated in terms of the relative decrease in hepatitis C incidence, prevalence, and mortality relative to 2015 and of the deaths and infections averted compared with a counterfactual of no treatment over the study period. We also estimated treatment rates needed to reach Georgia's elimination target.

findingsFrom May 1, 2015, to Feb 28, 2019, 54 313 patients were treated, with approximately 1000 patients treated per month since mid 2017. Compared with 2015, our model projects that these treatments have reduced the prevalence of adult chronic hepatitis C by a median 37% (95% credible interval 30-44), the incidence of chronic hepatitis C by 37% (29-44), and chronic hepatitis C mortality by 14% (3-30) and have prevented 3516 (1842-6250) new infections and averted 252 (134-389) deaths related to chronic hepatitis C. Continuing treatment of 1000 patients per month is predicted to reduce prevalence by 51% (42-61) and incidence by 51% (40-62), by the end of 2020. To reach a 90% reduction by 2020, treatment rates must increase to 4144 (2963-5322) patients initiating treatment per month.

interpretationGeorgia's hepatitis C elimination programme has achieved substantial treatment scale-up, which has reduced the burden of chronic hepatitis C. However, the country is unlikely to meet its 2020 elimination target unless treatment scales up considerably.

fundingCDC Foundation, National Institute for Health Research, National Institutes of Health.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolDisease EradicationEpidemicsFemaleGeorgia (Republic)Hepatitis C, ChronicHumansIncidenceInfantInfant, NewbornMale

Identifiers

PMID31864917
PMCPMC7025283
OpenAlexW2996039705

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.