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A Population-based survey for the prevalence of Hepatitis C Virus Infection in Georgia. Ana Kasradze National Center for Disease Control and Public Health September 6, 2014. Rationale for Survey. Georgia may be among countries with highest HCV burden worldwide

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A Population-based survey for the prevalence of Hepatitis C Virus Infection in Georgia

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A population based survey for the prevalence of hepatitis c virus infection in georgia

A Population-based survey for the prevalence of Hepatitis C Virus Infection in Georgia

Ana Kasradze

National Center for Disease Control and Public Health

September 6, 2014


Rationale for survey

Rationale for Survey

  • Georgia may be among countries with highest HCV burden worldwide

  • Limited data on national HCV prevalence, risk factors and population at risk

    (Tbilisi survey > 10 years prior)

  • Need for high quality serporevalence data

    (Disease burden)

  • Need to describe genotypes

    (treatment and response)

  • Georgia Ministry of Health priority


Hcv genotypes in georgia

HCV Genotypes in Georgia

*Source: Stvilia, et al: J Urban Health; 83(2):2006:289-298;.

†Bouscaillou, J., et al. (2014). : Int J Drug Policy

¶Karchava, et al: Georgia Medical News: 2009 Dec; (177): 51-55


Objectives

Objectives

  • Primary Objective: Estimate the prevalence of HCV infection in the general population by age groups, regions, and urban/rural residence

  • Secondary Objectives

    • Assess risk factors for HCV infection in Georgia

    • Describe HCV circulating genotypes

    • Identify knowledge and perceptions towards hepatitis and its prevention and treatment


Survey

Survey

  • Design:multistage, cluster, random sampling

  • Population: males and females > 18 years of age, residing in randomly selected households in Georgia.

  • Sample size: total approximately 7,000

    (based on 95% confidence interval +/- 1%, design effect of 2,

    30% non-response rate)

  • Stratification: 16 Strata (10 regions + 6 cities)

    • Tbilisi (sample of 1000, including 200 IDU)

    • Telavi, Kutaisi, Batumi, Zugdidi , Rustavi (sample of 400*5=2000, including 500 IDU)


Idu subsample

IDU Subsample

  • Additional sample of the IDU population within the 6 sampled cities of Georgia

  • Design - Snowball sampling

    any self-reporting IDU respondents other IDUs with whom they have contact

  • Will be analyzed independently of the main seroprevalence sample

  • Will give stronger prevalence estimates for this high-risk group


Data collection team

Data Collection Team

  • Survey Instrument – Questionnaire

    • Household information

    • Socio-demographic data

    • Medical History

    • Lifestyle information

    • Knowledge, Attitudes, Perceptions

  • Specimen - venous blood


A population based survey for the prevalence of hepatitis c virus infection in georgia

HCV Testing Algorithm

Anti-HCV

Anti-HCV Positive

Anti-HCV Negative

HCV RNA

HCV RNA Positive

HCV RNA Negative

HCV Genotyping


Analysis

Analysis

  • HCV prevalence in Georgia (+/- 1%) and

    • Cities (6)

    • Regions (10)

    • Bivariate analysis assessing association between factors (demographic/risk) and HCV infection

  • Multivariate logistic regression

    • models examining association between independent variables and HCV infection

  • HCV Genotype distribution


Benefits

Benefits

  • National/Regional by Urban/Rural Data

    • HCV infection prevalence (burden)

    • Risk factors for transmission (prevention)

    • Genotype distribution (care and treatment)

  • Laboratory capacity building

  • Epidemiology capacity building

  • Additional research/studies (stored sera)


Next steps serosurvey

Next Steps (Serosurvey)

  • Protocol (finalize and submit to IRB)

  • Recruitment of Teams

  • Training and Validation of Survey Tool

  • Fieldwork

  • Laboratory Analysis and Capacity Building

  • Data Analysis/Modeling

  • Publication of Results


Acknowledgments

Acknowledgments

  • US Centers for Disease Control and Prevention (CDC)

  • Emory University SPH and SOM

  • University of Bristol

  • Division of Viral Hepatitis/NCHHSTP/CDC


Thank you

Thank you!


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