Increased HIV Case Detection through Integration of HIV Testing in Georgian Hepatitis C Elimination Program Screening Activities

Abstract

In 2015 Georgia launched unprecedented National Hepatitis C Elimination Program, aiming to dramatically decrease
HCV prevalence in the country by 2020. Currently seroprevalence of HCV infection in Georgia is 7.7%, based on the
results of the population based cross-sectional household serosurvey, “Identify Persons infected with HCV” is one of
the strategic directions of the 5-year Strategic Plan for The Elimination of Hepatitis C Virus in Georgia, developed in
2016. To increase the proportion of persons who know their HCV infection status, the HCV screening component has
been added to the Hepatitis C Elimination program since June, 2016. Georgia announced free of charge screening for
any citizen of Georgia who wants to know status, irrespective of risk factor. In addition, tandem testing on HIV infection was offered to every person willing to be tested for HCV. The tests were granted by the Global Fund to fight AIDS,
TB and Malaria. Starting from November, 2015, any citizen of Georgia can obtain free HCV and HIV testing at the National Center for Disease Control and Public Health including its regional branch. Both HIV and HCV testing are performed by rapid immune chromatographic tests. 67,484 voluntary HCV testing and 29,765 HIV testing were performed
at NCDC and its regional network. Rate of positive HCV test result was 18%. Rate of positive HIV test result was 0.3%
(84 out of 29,765). Out of 84 volunteers who tested positive, further diagnostic procedures confirmed HIV in 42 and all
of them are enrolled in the HIV treatment program. Considering the low prevalence of HIV in Georgia, extra cases
found by the combined screening approach was significant contribution for early detection of asymptomatic HIV cases.
Nationwide HCV elimination program appears to be an effective mechanism that can be used to increase case detection
of HIV in Georgia and Integration of HIV testing within HCV screening should be maintained and expanded.