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- Title
Impact of Hepatitis C Virus Infection and Treatment on Mortality in the Country of Georgia, 2015–2020.
- Authors
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
- Abstract
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
GEORGIA; HEPATITIS C prevention; HEPATITIS C treatment; CAUSES of death; CONFIDENCE intervals; TREATMENT effectiveness; VIREMIA; DESCRIPTIVE statistics; LONGITUDINAL method; GOAL (Psychology)
- Publication
Clinical Infectious Diseases, 2023, Vol 77, Issue 3, p405
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad182