| Abstract | Retrospektivnom epidemiološkom studijom odredile su se epidemiološke karakteristike inficiranih hepatitis C virusom (HCV) i određen je dominantni način prenošenja kao i rizik stjecanja infekcije u Županiji splitsko-dalmatinskoj i istarskoj. Promatrano je razdoblje od 1999. do 2003. godine. U tom razdoblju u ove dvije županije koje čine 15% stanovništva Hrvatske broj prijavljenih oboljelih bio je 406 ili 45,77% od svih prijavljenih oboljelih od hepatitisa C u Hrvatskoj. Prosječna godišnja stopa oboljelih u tom razdoblju u Županiji splitsko-dalmatinskoj je 12,3%ooo, u Županiji istarskoj 11,6 %ooo, u cijeloj Hrvatskoj 4,0%ooo, a u dijelu Hrvatske bez navedenih županija 2,5%ooo. Hepatitis C u Županiji splitsko-dalmatinskoj i istarskoj predstavlja javno-zdravstveni problem jer su stope pobola trostruko više nego prosjek Hrvatske. U obje županije većinu oboljelih (72,6%) čine muškarci, koji obolijevaju u mlađoj životnoj dobi, nego žene. Životna dob svih inficiranih muškaraca iznosi 31,2±12 godina (min-maks: 4-83), a svih žena 36,2±17 godina (min-maks:10-77). Muškarci Županije splitsko-dalmatinske obolijevaju najranije - prosječna životna dob je iznosila 29,8 10 godina, a prosječna životna dob inficiranih žena je za 4,8 godina veća, nego muškaraca (p<0,001). Najveći dobno specifični pobol u obje županije, kod oba spola je u dobnoj skupini od 20 do 29 godina. Kod muškaraca je pobol u ovoj dobnoj skupini izrazito visok i iznosi 379,6%ooo u Županiji splitsko-dalmatinskoj i 302,2%ooo u Županiji istarskoj. Rizik stjecanja infekcije je 1,7 puta veći u Istarskoj županiji. Najveći broj inficiranih u Splitsko-dalmatinskoj (140; 79%) i Istarskoj županiji (93; 93%) pripadao je rizičnoj skupini intravenskih korisnika opojnih droga. Za 79 ovisnika s područja Splitsko/dalmatinske županije postoje podaci o genotipu: kod njih ukupno 54 (68,4%) je dokazan genotip 3a i 1a za koji se prenose intravenskom uporabom opojnih droga. Stopa anti-HCV + davatelja krvi u obje županije viša je nego u Hrvatskoj. U Županiji splitsko-dalmatinskoj, iako je prosječna stopa anti-HCV pozitivnih davatelja krvi viša nego u Hrvatskoj, ipak pokazuje trend pada. U Istri stopa anti-HCV + davatelja krvi pokazuje trend porasta. Postoji pozitivna korelacija između stope liječenih ovisnika na 100.000 stanovnika, stope inficiranih i stope anti-HCV+ davatelja krvi. Potvrđena je hipoteza da je dominantni način prenošenja HCV infekcije u Splitsko-dalmatinskoj županiji intravenska primjena opojnih droga. Isti put prenošenja, još je izraženiji u Istarskoj županiji. |
| Abstract (english) | The aim of this retrospective epidemiolologic study was to determine epidemiological characteristics of hepatitis C virus infected inhabitants and also dominate route of transmission and risk of acquiring infection in County of Split-Dalmatia and Istra county in Croatia. Select period is from 1999 to 2003. In that period in observed counties, which share 15% of Croatian inhabitants, number of patients was 415 or 46,78% of all patients from hepatitis C virus infection in Croatia. Average annual rate of patients with HCV infection was 12,3%ooo for Split-Dalmatia county, 11,6 %ooo for Istra county, 4,0%ooo for Croatia, and 2,5%ooo for rest of Croatia. Hepatitis C is one of major public health issues in County of Split-Dalmatia and Istra county. Average annual rates of patients with HCV infection are three times of average Croatian values. In both county men were majority among HCV patients (72,6%) and younger then women. Maternal age of all men was 31,2±12 (min-max: 4-83), and of all women 36,2±17 (min- max:10-77). Men infected with HCV were the youngest in Split-Dalmatia County; with average maternal age 29,8 10. Average maternal age of women infected with HCV was 4,8 years more then men in Split-Dalmatia County (p<0,001). The uttermost age specific morbidity at both sex was between 20-29 years of age in both county. The morbidity of infected men was 379,6%ooo in County of Split-Dalmatia and 302,2%ooo in Istra county. The risk of acquiring HCV infection was 1,7 times more in Istra county. The major proportion of patients belonged to risk group of injecting drug users -140/314 or 44,6% in County of Split-Dalmatia and 93/237 or 39,2% in Istra county. There are genotypes datas for 79 injecting drug users from County of Split-Dalmatia. 59 of them (74,7%) were infected with subtype 3a and 1a which are strongly associated with intravenous drug addiction. Rate of anti-HCV positive blood donors in both counties was higher then in Croatia. In County of Split-Dalmatia, there is easy curve among anti-HCV positive blood donors. In Istra county,.the rate of anti-HCV positive blood donors was showing growth trend.There was positive correlation between rate of treated intravenous drug addicts on 100.000 inhabitants, rate of HCV infected and rate of anti-HCV positive blood donors. The hypotesis was confirmed that the dominate way of transmission of HCV infection was injecting illegal drug use in County of Split-Dalmatia. The same way of transmission but more expressed was in Istra county. |
