Sociodemografski profil zavisnika od opijata koji su u povećanom riziku od infekcije HBV, HCV, HIV, Treponema pallidum, Cryptococcus neoformans, Pneumocystis carini i WNV
Sociodemographic profile of opiate addicts at increased risk of infection with HBV, HCV, HIV, Тreponema pallidum, Cryptococcus neoformans, Pneumocystis carini and WNV
Докторанд
Borovčanin, NemanjaМентор
Ristanović, ElizabetaЧланови комисије
Balint, BelaČanović, Predrag
Jovanović, Ivan
Метаподаци
Приказ свих података о дисертацијиСажетак
Uvod. Zavisnici od opijata predstavljaju visokorizičnu grupu zbog međusobnih
infekcija krvno-prenosivim bolestima, vertikalne transmisije patogena, kao i zbog
mogućnosti da budu potencijalni donori krvi (naročito kao plaćeni davaoci).
Cilj. Cilj našeg istraživanja bio je određivanje socio-demografskog profila 99
zavisnika od opijata Šumadijskog okruga lečenih u Kliničkom centru Kragujevac
supstitucionom terapijom metadonom i buprenorfinom, kao i određivanje prevalence
infekcija krvno-prenosivim patogenima: virus hepatitisa tip B, virus hepatitisa tip
C, virus stečene imunodeficijencije (HBV, HCV, HIV) i sifilis (Treponema pallidum),
kao i Cryptococcus neoformans, Pneumocystis carini i virus Zapadnog Nila (West Nile Virus
– WNV).
Metode: Ispitanici su odgovarali na pitanja iz Pompidu upitnika i podaci iz ovog
upitnika su korišćeni za analizu osnovnih socio-demografskih karakteristika. Svi
uzorci su testirani korišćenjem ELISA (Enzyme – Linked ImmunoSorbent Assay)/CIA
(Chemiluminescent I...mmuno – Assay) testova za virus hepatitisa tip B, virus hepatitisa
tip C, virus stečene imunodeficijencije (HBV, HCV, HIV) i sifilis (Treponema
pallidum), kao i korišćenjem PCR (Polymerase Chain Reaction) za HBV, HCV, HIV,
Cryptococcus neoformans, Pneumocystis carini i virus Zapadnog Nila (West Nile Virus –
WNV).
Rezultati: Najveći broj ispitanika je bio muškog pola (81,8 %), starosti 32 (19 – 57)
godine, 99 % je živelo u gradu, nezaposlenih je bilo 58,6 %, sa završenom srednjom
školom 67,7 %, a korisnika neadekvatne primene igala 34,3 %. Netestiranih na HBV je
39,4 %, na HCV 36,4 %, HIV 28,3 %, a samo njih 4 (4 %) je primilo vakcinu protiv HBV.
Što se tiče analiza na prisustvo HBV infekcije, ELISA/CIA i PCR negativnih je bilo
66, HBV ELISA/CIA i PCR pozitivnih je bilo 19, HBV ELISA/CIA-negativnih / PCRpozitivnih 12 i HBV ELISA/CIA-pozitivnih / PCR-negativnih 2 ispitanika. Testiranje
na HCV infekciju je pokazalo sledeće: ELISA/CIA i PCR negativnih ispitanika je bilo
15, HCV ELISA/CIA i PCR pozitivnih je bilo 58, HCV ELISA/CIA-negativnih / PCRpozitivnih 11, a HCV ELISA/CIA-pozitivnih / PCR-negativnih 15. Svi ispitanici su
bili negativni na HIV (ELISA/CIA i PCR testiranje), kao i na patogene oportunističkih
infekcija (Cryptococcus neoformans; Pneumocystis carini; PCR testiranje) i na prisustvo
WNV (PCR testiranje). Jedan ispitanik je bio pozitivan na sifilis (ELISA testiranje).
Zaključak: Naši rezultati su pokazali da je pozitivnost na prisustvo patogena krvnoprenosivih bolesti HBV i HCV visoka u ispitivanoj grupi zavisnika od opijata i
iznosi 33,4 % i 84,8 %. Preporuka bi bila da oni budu periodično testirani na
prisustvo HBV, HCV i HIV, komplementarnim ELISA/CIA i PCR testovima, obzirom na
izvestan stepen diskrepance u dobijenim rezultatima serološkog i molekulskog
testiranja.
Background/Aim. Intravenous drug users (IDUs) are still a high risk-group for cross-reacting
blood-borne infections, for vertical pathogen transmission, as well as for potentially blood/plasma
donation (particularly as "payed" donors). The aim of our study was to establish the profile of opiate
addict and prevalence of blood-borne pathogens – Hepatitis B virus (HBV), Hepatitis C virus
(HCV), Human Immunodeficiency Virus (HIV), Treponema pallidum, Cryptococcus neoformans,
Pneumocystis carini and West Nile Virus – WNV among 99 patients on substitution therapy with
methadone and buprenorphine from Shumadia District.
Methods. The Treatment Demand Indicator (TDI) of Pompidou-questionnaire was used to assess
the history of drug abuse and risk behavior. All blood samples were tested for HBV, HCV, HIV and
Treponema pallidum by Enzyme-Linked ImmunoSorbent Assay (ELISA) or Chemiluminescent
Immuno-Assay (CIA). Investigations were also performed for HBV, HCV, HIV, Cryptococcus
neoformans, Pneumocy...stis carini and West Nile Virus – WNV by molecular testing – Polymerase
Chain Reaction (PCR) method.
Results. The majority of patients were male (81.8 %), median age 32 (19 – 57) years, lived in a city
(99 %), unemployed (58.6 %), with finished secondary school (67.7 %), unsafe injecting practices
(34.3 %) and never previously tested for HBV (39.4 %), HCV (36.4 %) nor HIV (28.3 %); only
four percentage of them previously got HBV-vaccine. Complementary testings resulted with the
following results: HBV ELISA/CIA and PCR negativity for 66 patients and positive results (by
ELISA/CIA and PCR) for 19 patients. However, a difference was observed in ELISA/CIAnegative / PCR-positive result for 12 and ELISA/CIA-positive / PCR-negative for two patients,
respectively. Further, negative results for HCV (ELISA/CIA and PCR testing) were found in 15
IDUs and positive results (using both methods) were found in 58 patients. Different results for
ELISA/CIA-negative / PCR-positive results were found in 11 IDUs and ELISA/CIApositive / PCR-negative results were found in 15 patients. All investigated IDUs were negative for
HIV (ELISA/CIA and PCR testing) and for pathogens of opportunistic infection (Cryptococcus
neoformans; Pneumocystis carini; PCR testing), as well as for West Nile Virus (PCR testing). Just
one IDU was positive for syphilis (ELISA and confirmatory testing).
Conclusion. This study undoubtedly confirmed the effectiveness and improved safety of originally
designed complementary (ELISA/CIA and PCR) pathogen monitoring system. Our study
demonstrated that the positivity for HBV and HCV is still very high (33.4 % and 84.8 %,
respectively) in IDUs. Thus, we suggest that drug users have to be periodically screened using a
complementary serological/molecular testing, also concerning differences/discrepancies in results
obtained using these methods.