Kolarić Branko, Stajduhar Dinko, Gajnik Davorin, Rukavina Tomislav, Wiessing Lucas
Public Health, Social Medicine and Gerontology Service, Zagreb County Institute of Public Health, Zagreb, Croatia.
Cent Eur J Public Health. 2010 Jun;18(2):104-9. doi: 10.21101/cejph.a3576.
Similar to some other Central European countries, Croatia has low HIV prevalence among injecting drug users (IDUs) but high hepatitis C (HCV) prevalence. This may indicate different patterns of risk behaviour in this region than in other parts of Europe. The main objectives of this study were to assess the seroprevalence of HIV and hepatitis B and C and related risk factors among IDUs in the three largest Croatian cities (Zagreb, Split, Rijeka) and within the national prison system, as well as to apply a multiplier-method population size estimation of IDUs in Zagreb, Split and Rijeka. Recruitment sites were selected in collaboration with the local public health institutes, NGOs, Centers for treatment municipalities and the judiciary system. Participants were recruited during September and October 2007. Trained peer-recruiters were used to recruit IDU participants at treatment and harm reduction centres as well as pre-identified social, commercial and street based venues. Participants completed the study questionnaire and provided venous blood samples for HIV, hepatitis B and hepatitis C testing. The study included 601 participants, of whom 121 were recruited in Split, 130 in Zagreb, 150 in Rijeka and 200 in the prison system. The prevalence of positive anti-HCV tests was 65% in Split, 51% in Zagreb, 29% in Rijeka and 44% in the prisons. The prevalence of anti-HBcAg was 31% in Split, 13% in Zagreb, 9% in Rijeka and 24% in prison. No case of HIV infection was found. The estimated IDUs population sizes were 2,805 for Zagreb area, 3,347 for Split and 1,370 for Rijeka area, however confidence intervals were very large, indicating the need for larger samples. A high frequency of positive markers on hepatitis B virus and C virus in the population of injecting drug users in Croatia has been confirmed with this research, as well as a low prevalence of HIV infection. This may be related to relatively low levels of injecting risk behaviour and injecting frequency although it is not possible to make strong conclusions on risk behaviour, as participants were mostly recruited in harm reduction programmes. This research should be followed by targeted activities for reducing risks of infectious diseases among injecting drug users in the Republic of Croatia and future research at the national level.
与其他一些中欧国家类似，克罗地亚注射吸毒者（IDU）中的艾滋病毒流行率较低，但丙型肝炎（HCV）流行率较高。这可能表明该地区与欧洲其他地区的风险行为模式不同。本研究的主要目的是评估克罗地亚三个最大城市（萨格勒布、斯普利特、里耶卡）以及国家监狱系统中注射吸毒者的艾滋病毒、乙型和丙型肝炎血清流行率及相关风险因素，并采用乘数法对萨格勒布、斯普利特和里耶卡的注射吸毒者进行人口规模估计。招募地点是与当地公共卫生机构、非政府组织、治疗市立中心和司法系统合作选定的。参与者于2007年9月和10月招募。训练有素的同伴招募者在治疗和减少伤害中心以及预先确定的社会、商业和街头场所招募注射吸毒者参与者。参与者完成了研究问卷，并提供静脉血样用于艾滋病毒、乙型肝炎和丙型肝炎检测。该研究包括601名参与者，其中121名在斯普利特招募，130名在萨格勒布招募，150名在里耶卡招募，200名在监狱系统招募。斯普利特抗丙型肝炎病毒检测呈阳性的流行率为65%，萨格勒布为51%，里耶卡为29%，监狱为44%。抗乙肝核心抗原的流行率在斯普利特为31%，萨格勒布为13%，里耶卡为9%，监狱为24%。未发现艾滋病毒感染病例。萨格勒布地区注射吸毒者的估计人口规模为2805人，斯普利特为3347人，里耶卡地区为1370人，然而置信区间非常大，表明需要更大的样本。本研究证实了克罗地亚注射吸毒者群体中乙型和丙型肝炎病毒阳性标志物的高频率，以及艾滋病毒感染的低流行率。这可能与相对较低的注射风险行为水平和注射频率有关，尽管由于参与者大多是在减少伤害项目中招募的，因此无法就风险行为得出有力结论。克罗地亚共和国应开展针对性活动，以降低注射吸毒者中传染病的风险，并在国家层面开展未来研究，以跟进本研究。
