To assess the impact of the French national hepatitis C prevention programme initiated in 1999, we analysed trends in hepatitis C virus (HCV) prevalence, testing and characteristics of HCV-infected patient at first referral from 1994 to 2006. We used four data sources: Two national population-based sero-prevalence surveys carried out in 1994 and 2004; two surveillance networks, one based on public and private laboratories throughout France and the other on hepatology reference centres, which aim to monitor, respectively, trends of anti-HCV screening and of epidemiological-clinical characteristics of HCV patients at first referral.Between 1994 and 2004, the anti-HCV prevalence for adults aged 20-59 years decreased from 1.05 (95% confidence interval 0.75-1.34) to 0.71 (0.52-0.97). During the same period, those anti-HCV positive with detectable HCV RNA decreased from 81 to 57%, whereas, the proportion of anti-HCV positive persons aware of their status evolved from 24 to 56%. Anti-HCV screening activity increased by 45% from 2000 to 2005, but decreased in 2006 (-10%), while HCV positivity among those tested decreased from 4.3 to 2.9%. The proportion of cirrhosis at first referral remains around 10% between 2001 and 2006, with many patients with excessive alcohol consumption (34.7% among males) or viral co-infections (HIV seropositivity for 5.2% patients). Our analysis indicates that the national programme had a positive impact at the population level through improved prevention, screening and management. There is still a need to identify timely those at risk for earlier interventions, to assess co-morbidities better and for a multidisciplinary approach to HCV management.

Introduction: HIV is an emerging epidemic in Eastern Europe. Most HIV infections in this region have occurred among injection drug users (IDUs) and their sexual partners. The objective of this study was to determine the seroprevalence and risk behaviors for HIV, HBV, and HCV infection among IDUs in Georgia.Methods: Between 2000 and 2001, we studied 583 IDUs aged 18 to 46 years from 3 cities in Georgia. Tbilist, Poti, and Batumi, Structured questionnaires were administered to measure risk behaviors, including IDU, sexual, and other risks. Blood was drawn for HIV hepatitis B (HBV), and hepatitis C (HCV) serologies.Results: 401 (68.8%) participants were seropositive for HCV; 322 (55.2%) for HBV (HBsAg or anti-HBc): and 10 (1.7%) for HIV, Heroin (58.7%) was the most frequently used drug, followed by homemade drugs (31.6%) and opium, (9.8%). In multivariate analysis, risk factors, for HCV and HBV infection included unsafe cleaning practices for injection parapheralia. The number of drug-using partners was associated with HCV infection. Sexual risk factors (i.e., the number of sex partners, paying for sex, and a history of sexually transmitted infections [STIs] were associated with HIV but not with HCV infection. Those injecting homemade drugs and optium most frequently reported risky drug-using behavior.Discussion: Our data suggest a high prevalence of HBV and HCV infection among IDUs in Georgia associated with significant drug- and needle-sharing behaviors. HIV seroprevalence appears to be relatively low and is associated with risky sexual behaviors, rather than drug-using behaviors. Further research is needed among Georgian IDUs to develop effective prevention strategies and limit the transmission of HIV in this population.