{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:41:30Z","timestamp":1784288490136,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","funder":[{"name":"Task Force for Global Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>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\u20132020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad182","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T15:09:40Z","timestamp":1682521780000},"page":"405-413","source":"Crossref","is-referenced-by-count":6,"title":["Impact of Hepatitis C Virus Infection and Treatment on Mortality in the Country of Georgia, 2015\u20132020"],"prefix":"10.1093","volume":"77","author":[{"given":"Lia","family":"Gvinjilia","sequence":"first","affiliation":[{"name":"Eastern Europe and Central Asia Regional Office, Centers for Disease Control and Prevention , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8390-3325","authenticated-orcid":false,"given":"Davit","family":"Baliashvili","sequence":"additional","affiliation":[{"name":"The Task Force for Global Health , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Shadaker","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Averhoff","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levan","family":"Kandelaki","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, National Center for Disease Control and Public Health , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Kereselidze","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, National Center for Disease Control and Public Health , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengiz","family":"Tsertsvadze","sequence":"additional","affiliation":[{"name":"Clinic \u201cHepa,\u201d Tbilisi , Georgia"},{"name":"Infectious Diseases, AIDS and Clinical Immunology Research Center , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikoloz","family":"Chkhartishvili","sequence":"additional","affiliation":[{"name":"Infectious Diseases, AIDS and Clinical Immunology Research Center , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Butsashvili","sequence":"additional","affiliation":[{"name":"Health Research Union and Clinic NeoLab , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Metreveli","sequence":"additional","affiliation":[{"name":"Clinic \u201cMrcheveli,\u201d Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiran","family":"Gamkrelidze","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, National Center for Disease Control and Public Health , Tbilisi , Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige A","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"2023081421083474700_ciad182-B1","author":"World Health Organization"},{"key":"2023081421083474700_ciad182-B2","author":"World Health 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