The burden and epidemiology of hepatitis B and hepatitis D in Georgia: findings from the national seroprevalence survey

Objectives The burden of hepatitis B virus (HBV) and hepatitis D virus (HDV) infections is unknown in Georgia. This analysis describes the prevalence of hepatitis B and coinfection with HDV and the demographic characteristics and risk factors for persons with HBV infection in Georgia. Study design This is a cross-sectional seroprevalence study. Methods A cross-sectional, nationwide survey to assess hepatitis B prevalence among the general adult Georgian population (age ≥18 years) was conducted in 2015. Demographic and risk behavior data were collected. Blood specimens were screened for anti–hepatitis B core total antibody (anti-HBc). Anti-HBc–positive specimens were tested for hepatitis B surface antigen (HBsAg). HBsAg-positive specimens were tested for HBV and HDV nucleic acid. Nationally weighted prevalence estimates and adjusted odds ratios (aORs) for potential risk factors were determined for anti-HBc and HBsAg positivity. Results The national prevalence of anti-HBc and HBsAg positivity among adults were 25.9% and 2.9%, respectively. Persons aged ≥70 years had the highest anti-HBc positivity (32.7%), but the lowest HBsAg positivity prevalence (1.3%). Anti-HBc positivity was associated with injection drug use (aOR = 2.34; 95% confidence interval [CI] = 1.46–3.74), receipt of a blood transfusion (aOR = 1.68; 95% CI = 1.32–2.15), and sex with a commercial sex worker (aOR = 1.46; 95% CI = 1.06–2.01). HBsAg positivity was associated with receipt of a blood transfusion (aOR = 2.72; 95% CI = 1.54–4.80) and past incarceration (aOR = 2.72; 95% CI = 1.25–5.93). Among HBsAg-positive persons, 0.9% (95% CI = 0.0–2.0) were HDV coinfected. Conclusions Georgia has an intermediate to high burden of hepatitis B, and the prevalence of HDV coinfection among HBV-infected persons is low. Existing infrastructure for hepatitis C elimination could be leveraged to promote hepatitis B elimination.