title: [Prevalence of hepatitis B, hepatitis C and HIV among injecting drug users treated outpatiently and in therapeutic community in Brod-Posavina County, Croatia].
abstract: Blood transmitted diseases (hepatitis B, hepatitis C, HIV) are major public health problems. Drug users, especially injecting drug users (IDU), are by nature of their illness, a risk population for these diseases. The aim of the study was to determine the prevalence of blood transmitted diseases among IDU in the Brod-Posavina County due to shared use of needle/syringe in outpatients and those treated in a therapeutic community, and to compare the results obtained. First, we analyzed data separately for hepatitis B and C, and then we selected patients with coinfection. The prevalence of HBsAg positive patients in both groups was significantly lower than the prevalence among drug addicts in Croatia (1.16% and 3.28% vs. 13.2%). Significant correlation was found in outpatients with anti-HBs+anti-HBc antibody (p < 0.05) between those who shared needles/syringes and those who did not. Significant correlation was also found among patients treated at therapeutic community (p < 0.01). Comparing the patients treated as outpatients and in therapeutic community, significant correlation was only found between vaccinated patients. HCV positive outpatients had lower and drug addicts in therapeutic communities significantly higher prevalence as compared with the prevalence of HCV among addicts in Croatia (41.86% and 60.66% vs. 44.6%). A significant correlation between those who shared needles/syringes and those who did not was found in both outpatients and patients treated in therapeutic community (P < 0.01). Comparison of HCV positive patients treated as outpatients and those in therapeutic community also yielded significant correlation (p < 0.05). The prevalence of HBV/HCV coinfection was similar in both groups of patients. Significant correlation (P < 0.05) was only found in the group of patients with anti HBC/anti HCV antibodies. There was no HIV-positive patient in any group. We also found a low prevalence of HBsAg/anti-HCV in both groups of patients (1.16% and 2.46%). Upon establishing a network of centers for the treatment of addicts, constant work on prevention and education, systematic testing and vaccination, and implementation of harm reduction programs, we noticed a trend of reducing the number of people with HBV and HCV in the younger population of addicts.
authors.affiliation: Sluzba za javno zdravstvo, zastitu mentalnog zdravlja, prevenciju i izvanbolnicko lijecenje ovisnosti, Zavod za javno zdravstvo Brodsko-posavske zupanije, Slavonski Brod, Hrvatska. anakolovrat@gmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: Kolovrat
authors.forename: Irena
authors.initials: I
authors.lastname: Jurisić
authors.forename: Zorana
authors.initials: Z
authors.lastname: Marić
authors.forename: Ante
authors.initials: A
authors.lastname: Cvitković
mesh_terms: D000293:Adolescent; D000328:Adult; D017523:Croatia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000821:virology; D055815:Young Adult