engleski

Molecular epidemiology of hepatitis C virus in a population of intravenous drug users in Croatia

The aim of this study was to investigate clinical and virological characteristics of HCV infection among intravenous drug users (IDU) in Croatia and identify transmission networks and their correlates. Phylogenetic analysis of partial NS5B sequences obtained from 95 IDU with chronic HCV was performed. Transmission clusters were identified at 4.5% genetic distance and 70% bootstrap support threshold. Statistical analysis was performed by the Mann-Whitney test for continuous variables and the Chi-square test or the Fisher’s exact test categorical variables. A p-value < 0.05 was considered significant. Most of the patients were male (75/95, 78.9%) and infected with HCV subtype 1a (48/95, 50.5%) or subtype 3a (46/95, 48.4%). Eight transmission clusters were identified with 21 patients (21/95, 22.1%), predominantly in subtype 1a (17/48, 35.4%) (p=0.002). Subtype 1a sequences segregated in two distinct clades with transmission pairs present exclusively in clade I (p=0.002). Majority of the presumably epidemiologically linked patients had lower fibrosis stage (F1 – F2) (17/21, 81.0%, p =0.04). Age and gender did not seem to be associated with clustering. High prevalence of transmission clusters was observed in Croatian IDU, especially in subtype 1a, which suggests sharing of drug paraphernalia is a major driver of new infections. Better understanding of transmission dynamics in this population is necessary for implementation of successful programs for elimination of viral hepatitis as a public health threat.

hepatitis C virus ; intravenous drug use ; subtype 1a ; subtype 3a ; transmission cluster

nije evidentirano