Epidemiology of hepatitis C virus infection in Split-Dalmatia County

Abstract

Hepatitis C virus je rasprostranjen po cijelom svijetu, a najčešći uzrok visoke prevalencije uz intravensko uzimanje droga su nepravilnosti u postupanju pri parenteralnim zahvatima u zdravstvenim ustanovama. Hrvatska je zemlja niske prevalencije (manje od 2% stanovnika ima anti - HCV protutijela). Epidemiološka situacija odabrane populacije određuje koji dio te populacije ima najveću korist od programa ranog otkrivanja i liječenja bolesti. Cilj: Cilj istraživanja bio je utvrditi prevalenciju, rizične čimbenike, način inficiranja i distribuciju HCV genotipova kod različitih dobnih i spolnih grupa populacije Splitsko dalmatinske županije u usporedbi sa drugim županijama u Hrvatskoj. Materijali i metode: Radi se o retrospektivnom istraživanju anketiranjem kroničnih vironoša o načinu infekcije i dobi otkrivanja infekcije. Podaci o pacijentima su dobiveni iz nekoliko različitih izvora: Registar kroničnih vironoša HCV u Nastavnom zavodu za javno zdravstvo (NZZJZ) županije Splitsko-dalmatinske, registar Odjela infektologije KBC Split, registar Odjela transfuzije KBC Split, Registar HCV inficiranih u Službi za zarazne bolesti Hrvatskog Zavoda za javno zdravstvo te Hrvatski zdravstveno statistički ljetopis. U istraživanje su uključeni svi registrirani anti-HCV pozitivni pacijenti od 1993-2015. Plazma uzorci za molekularnu dijagnostiku HCV infekcije su prikupljeni kao dio rutinskog dijagnostičkog praćenja pacijenta s kroničnim hepatitisom C s ciljem određivanja i učinka terapije. Statistička analiza je izvršena programom SPSS 17.0. Rezultati: U Splitsko-dalmatinskoj županiji predominantan uzrok infekcije hepatitisom C je genotip 3 (49%) koji se javlja kod intravenskih korisnika droga. Postotci za žene i muškarce inficirane hepatitisom C u Splitsko-dalmatinskoj županiji bili su za žene (22%) te za muškarce (78%). Najčešća dobna skupina u kojoj su pacijenti prijavljivali infekciju hepatitisom C bila je od 20-39 godina. Zaključak: Povezanost između rizičnih čimbenika za infekciju i distribucije genotipova u podskupini pacijenata iz Splitsko-dalmatinske županije potvrđuje korelaciju između intravenskih korisnika droga i visoke prevalencije genotipa 3 hepatitisa C.Hepatitis C virus is widespread around the world, and the most common cause of high prevalence with intravenous drug use are irregularities in dealing with parenteral interventions in health care institutions. Croatia is the country of low prevalence (less than 2% of the population has an anti - HCV antibodies). The epidemiological situation of selected population determines which part of that population has the greatest benefit from the program of early detection and treatment of disease. Goal: The goal of this study was to determine the prevalence, risk factors, way of the infection and distribution of HCV genotypes within different age and sex groups of the population of Split-Dalmatia County compared to other counties in Croatia. Materials and methods: This retrospective study was guided by interviewing of chronic virus hosts about the way of infection and their age when infection was detected. Patients data were obtained from several different sources: the Register of chronic HCV Vironos of Teaching Institute for Public Health (NZZJZ) of Split-Dalmatia County, register of Infectious diseases department of KBC Split, register of Department of transfusion KBC Split, register of HCV infected patients in the Department of Infectious Diseases from Croatian Institute for Public Health and Croatian statistical year book. The study includes all registered anti-HCV positive patients from 1993 to 2015. Plasma samples for molecular diagnosis of HCV infection have been collected as a part of routine diagnostic monitoring of the patients with chronic hepatitis C with the aim of determining the effect of therapy. Statistical analysis was performed using the SPSS 17.0. Results: In Split-Dalmatia County predominant cause of the hepatitis C infection is genotype 3 (49%) that occurs within intravenous drug users. The percentages of women and men infected with hepatitis C in SDC were women (22%) and men (78%). The most common age group in which patients were reporting to be infected with hepatitis C was 20-39 years old. Conclusion: The relationship between risk factors for infection and distribution of genotypes in a subset of patients from the Split-Dalmatia County confirms the correlation between injecting drug users and the high prevalence of genotype 3 hepatitis C