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

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.