Demographic and Clinical Characteristics of Patients With Hepatitis C and Hepatitis B Co-Infection, Georgia, 2017–2023

Abstract

Persons co-infected with hepatitis C virus and hepatitis B virus (HCV-HBV) are at increased risk of developing liver disease compared with mono-infected individuals. In Georgia, all patients undergoing hepatitis C treatment are eligible for free testing for hepatitis B surface antigen (HBsAg). However, further hepatitis B evaluations and treatment are not free. We explored demographic and clinical characteristics associated with HCV-HBV co-infection among persons treated for HCV infection. Persons aged ≥ 18 years with HCV infection who initiated HCV treatment during 2017–2023 were included. Patients were grouped as HCV mono-infected, HCV-HBV co-infected (HBsAg positive), and HBV exposed (total HBV core antibody positive, HBsAg negative). We present descriptive analysis and adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI). Of 54,994 adults treated for hepatitis C, 68.1% had HCV mono-infection, 29.3% were previously exposed to HBV, and 2.6% had HCV-HBV co-infection. Persons who were aged 18–45 years (aPR: 1.75, 95% CI: 1.48–2.08), male (aPR: 1.38, 95% CI: 1.11–1.71), reported ever injecting drugs (aPR: 1.40, 95% CI: 1.19–1.66), had end-of-HCV treatment, alanine transaminase (ALT) levels > 80 IU/L (aPR: 2.14, 95% CI: 1.40–3.29) and did not achieve hepatitis C cure after treatment (aPR: 1.83, 95% CI: 1.13–2.95) were more likely to have HCV-HBV co-infection vs. HCV mono-infection. Patients who did not achieve cure and had persistently higher ALT levels after hepatitis C treatment were more likely to have HCV-HBV co-infection. Expanded access to hepatitis B care and treatment, and co-management of HBV infection along with HCV treatment in co-infected persons are needed to improve clinical outcomes.