Risk factors and genotype distribution of hepatitis C virus in Georgia: A nationwide population-based survey

• Type of Material: Article
• Authors: Davit Baliashvili, National Center for Disease Control and Public Health; Francisco Averhoff, Centers for Disease Control and Prevention, Atlanta; Ana Kasradze, National Center for Disease Control and Public Health; Stephanie J Salyer, Div Global Hlth Protect; Giorgi Kuchukhidze, National Center for Disease Control and Public Health, Tbilisi; Amiran Gamkrelidze, National Center for Disease Control and Public Health, Tbilisi; Paata Imnadze, National Center for Disease Control and Public Health, Tbilisi; Maia Alkhazashvili, National Center for Disease Control and Public Health, Tbilisi; Gvantsa Chanturia, National Center for Disease Control and Public Health, Tbilisi; Nazibrola Chitadze, National Center for Disease Control and Public Health, Tbilisi; Roena Sukhiashvili, National Center for Disease Control and Public Health, Tbilisi; Curtis Blanton, Centers for Disease Control and Prevention, Atlanta, Georgia; Jan Drobeniuc, Centers for Disease Control and Prevention, Atlanta; Juliette Morgan, Centers for Disease Control and Prevention, Atlanta
• Language: English
• Date: 2022-01-21
• Publisher: PUBLIC LIBRARY SCIENCE
• Publication Version: Final Published Version
• Copyright Statement: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
• License: Creative Commons Attribution 1.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0262935
• Title of Journal or Parent Work: PLOS ONE
• Volume: 17
• Issue: 1
• Start Page: e0262935
• End Page: e0262935
• Grant/Funding Information: This study analyzed data from a serosurvey originally funded by the government of Georgia and the USCDC and previously published (Hagan et.al., 2019). This work was supported in part by the NIH Fogarty International Center Global Infectious Diseases grant D43TW007124 (to DB). There was no additional external funding received for this study.
• Keywords: TRANSMISSION; Multidisciplinary Sciences; HIGH PREVALENCE; INFECTION; HIV; ELIMINATION; Science & Technology - Other Topics; HCV-RNA; Science & Technology; SOFOSBUVIR/VELPATASVIR; PROGRESS; BEHAVIORS

Abstract

In preparation for the National Hepatitis C Elimination Program in the country of Georgia, a nationwide household-based hepatitis C virus (HCV) seroprevalence survey was conducted in 2015. Data were used to estimate HCV genotype distribution and better understand potential sex-specific risk factors that contribute to HCV transmission. HCV genotype distribution by sex and reported risk factors were calculated. We used explanatory logistic regression models stratified by sex to identify behavioral and healthcare-related risk factors for HCV seropositivity, and predictive logistic regression models to identify additional variables that could help predict the presence of infection. Factors associated with HCV seropositivity in explanatory models included, among males, history of injection drug use (IDU) (aOR = 22.4, 95% CI = 12.7, 39.8) and receiving a blood transfusion (aOR = 3.6, 95% CI = 1.4, 8.8), and among females, history of receiving a blood transfusion (aOR = 4.0, 95% CI 2.1, 7.7), kidney dialysis (aOR = 7.3 95% CI 1.5, 35.3) and surgery (aOR = 1.9, 95% CI 1.1, 3.2). The male-specific predictive model additionally identified age, urban residence, and history of incarceration as factors predictive of seropositivity and were used to create a male-specific exposure index (Area under the curve [AUC] = 0.84). The female-specific predictive model had insufficient discriminatory performance to support creating an exposure index (AUC = 0.61). The most prevalent HCV genotype (GT) nationally was GT1b (40.5%), followed by GT3 (34.7%) and GT2 (23.6%). Risk factors for HCV seropositivity and distribution of HCV genotypes in Georgia vary substantially by sex. The HCV exposure index developed for males could be used to inform targeted testing programs.