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The trend in the number of low-threshold facilities performing tests for these infections and the numbers of tests conducted according to the information provided in the final reports of the projects supported as part of the GCDPC subsidy proceedings are given in Table 7-7 (p. 109) in the chapter on Prevention and Treatment of Drug-related Infectious Diseases. The data about testing for infections and the results of the tests are also recorded by the Register of Treatment Demands (Studničková and Petrášová, 2011). This information is provided by the clients themselves or is obtained from their files; only tests with known results are included; see Table 6-6. Although they provide limited evidence only, the data indicate a stable and, in recent years, falling prevalence of infections among drug users (in line with the observed trends in new cases of viral hepatitis in the Czech Republic reported in the EPIDAT official register of infectious diseases – see above). Table 6-6: Results of testing for HIV, HAV, HBV, and HCV among IDUs demanding treatment, self-reported in 2003– 2010 (Studničková and Petrášová, 2011) HIV HAV HBV HCV Year Positive Positive Positive Positive Total tested Total tested Total tested Total tested tests % tests % tests % tests % 2003 2,471 0.8 2,132 7.1 2,504 11.2 2,884 31.5 2004 2,483 0.4 2,059 5.5 2,581 9.9 2,913 33.6 2005 2,253 0.2 1,931 4.5 2,332 10.1 2,577 35.0 2006 2,196 0.5 1,997 3.3 2,290 10.0 2,497 32.6 2007 1,905 0.3 1,774 3.3 2,004 8.4 2,168 31.0 2008 2,332 0.6 2,271 8.4 2,463 8.9 2,636 32.0 2009 2,558 0.5 2,307 6.1 2,553 8.3 2,852 29.8 2010 2,865 0.6 2,515 5.8 2,837 8.1 3,189 30.4 Of the 2,113 people registered in the Substitution Treatment Register in 2010, between 147 and 166 persons were tested for the various infectious diseases under scrutiny, depending on the type of test. HIV prevalence was at 0.6%, HBV prevalence at 54%, and HCV prevalence at 68%. Of the 160 anti-HCV-positive individuals, 131 were tested for direct identification of the HCV virus (HCV PCR-RNA), of whom 66 (50.4%) tested positive, indicating an active ongoing HCV infection (Nechanská, 2011g); see Table 6-7. When interpreting these results, however, it is necessary to take into account the fact that only a small proportion of registered patients were tested for the infections and in many cases the tests were likely to be targeted at people with problems or a suspected infection. Therefore, the results tend to overestimate the true prevalence of infection among substitution treatment patients, as evidenced by, inter alia, a higher rate of positive tests among new clients. Table 6-7: Results of testing for HIV, HBV, and HCV among patients on opiate substitution in 2010 (Nechanská, 2011g) All clients New clients Infection Tested Total Positive Total Positive marker Positive Positive tested tests % tested tests % HIV anti-HIV 160 1 0.6 91 0 0 HBsAg* 166 13 7.8 96 9 9.4 HBV anti-HBcAg** 147 79 53.7 85 49 57.6 anti-HBsAg** 160 67 41.9 88 42 47.7 HCV anti-HCV 160 109 68.1 91 70 76.9 Note: * An antigen indicating acute or chronic active infection; ** anti-HBcAg are antibodies generated during an acute HBV infection, but lasting even long after recovery; anti-HBsAg antibodies have a similar information value, but also develop after vaccination; when interpreting the results it should be taken into account that these may not be examinations of the same people. For 2010, the results of the testing of imprisoned injecting drug users are available (Generální ředitelství Vězeňské služby ČR, 2011d). The sample of prisoners is not representative and repeated tests of the same (positive) person in the various stages of serving a custodial sentence cannot be excluded. Therefore, caution must be exercised in the interpretation and generalisation of the results. Nevertheless, the results indicate a higher rate of infection among prisoners in comparison with available results of studies and monitoring systems aimed at drug users in the community-based facilities – in particular, the prevalence of HIV (even though the number of persons examined is low) is relatively high; see Table 6-8. page 89
Table 6-8: Results of testing for HIV, HBV, and HCV among injecting drug users in prisons in 2010 (Generální ředitelství Vězeňské služby ČR, 2011d) Infection Tested indicator Start of serving Start of In the course of prison sentence remand prison sentence Total tested 67 68 912 HIV anti-HIV Positive 3 4 3 Positive (%) 4.5 5.9 0.3 Total tested 1,790 1,144 1,454 HBsAg* Positive 194 117 183 HBV Positive (%) 10.8 10.2 12.6 Total tested 1,644 935 1,210 Positive 361 249 313 anti-HBc IgG ** Positive (%) 22.0 26.6 25.9 Total tested 4,776 1,304 1,611 Positive 1,097 619 704 HCV anti-HCV Positive (%) 23.0 47.5 43.7 Note: * An antigen indicating acute or chronic active infection; ** antibodies generated during an acute HBV infection but lasting even long after recovery. 6.1.4 Risk Behaviour of Drug Users While there has been a slight decline in the proportion of injecting users among first-time treatment demands in connection with heroin and pervitin use in the long term, the latest available data indicate that this trend may be changing. Subutex ® users report a high proportion of administration by injection. In the Czech Republic, cocaine is used almost exclusively by snorting (two out of a total of 23 cocaine users reported injection as the route of administration in their demands for treatment in 2010). No treatment demands related to crack use were registered in 2010 (Studničková and Petrášová, 2011). Trends in the proportion of injecting users among patients in outpatient psychiatric treatment are provided in Figure 6-8 (Nechanská, 2011c). The proportion of injecting use among heroin and pervitin users has been decreasing in the long term, and is lower than in the Register of Treatment Demands (Figure 6-7). The long-term rising percentage of injecting drug users among polydrug users (dg. F19) is probably a reflection of the growth in the number of pervitin and opiate users who combine these two drugs together or with other drugs. page 90
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Annual Report The Czech Republic 20
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Annual Report: The Czech Republic -
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PART B: SELECTED ISSUES............
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In 2010 the very first representati
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In the Czech Republic, the treatmen
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PART A: NEW DEVELOPMENTS AND TRENDS
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ange applies to addictologists who
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Republic has been reporting the hig
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Wenceslas Square and in the surroun
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Regions of the Czech Republic to ca
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Region Pardubice Vysočina South Mo
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educe drug supply (particularly to
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Map 1-1: 2010 drug policy expenditu
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Total state budget Regions Table 1-
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1.3.2 Drug Treatment Costs Incurred
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Table 1-9: Costs incurred by health
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2 Drug Use in the General Populatio
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Table 2-2: Prevalence rates of use
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The M-CIDI questionnaire, containin
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Table 2-6: Prevalence rates of use
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Figure 2-2: Attitudes towards crimi
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Page 47 and 48: Table 2-8: 2010 Safer Party clients
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Page 51 and 52: partly also by regional public heal
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Page 59 and 60: Table 4-4: Prevalence estimates of
Page 61 and 62: The general population studies (see
Page 63 and 64: Information on treatment and counse
Page 65 and 66: 5.2.1 Professional Competency of Se
Page 67 and 68: Table 5-6: Number of outpatient hea
Page 69 and 70: Table 5-8: Number of healthcare fac
Page 71 and 72: The proportions found for prescribi
Page 73 and 74: Map 5-2: Sobering-up station networ
Page 75 and 76: Table 5-14: Network of inpatient fa
Page 77 and 78: care centres report to diagnostic i
Page 79 and 80: cannabis, especially among adolesce
Page 81 and 82: Map 5-4: Number of all treatment de
Page 83 and 84: Figure 5-8: Selected characteristic
Page 85 and 86: 5.3.3.2 Clients in Opiate Substitut
Page 87 and 88: Figure 5-10: Trends in the capacity
Page 89 and 90: Table 5-23: Number of hospitalisati
Page 91 and 92: Table 6-1: Number of newly detected
Page 93 and 94: Figure 6-5: Reported incidence of s
Page 95: The monitoring of testing for infec
Page 99 and 100: Table 6-9: Sharing of needles and s
Page 101 and 102: tests for cannabis; see Table 6-12.
Page 103 and 104: Pervitin was the cause of a fatal o
Page 105 and 106: Table 6-15: Deaths with the presenc
Page 107 and 108: Table 6-17: Fatal drug overdoses in
Page 109 and 110: Figure 6-13: Comparison of trends i
Page 111 and 112: 7 Responses to Health Correlates an
Page 113 and 114: Table 7-2: Selected services of low
Page 115 and 116: Map 7-2: Number of needles and syri
Page 117 and 118: Table 7-8: History of HBV, HCV, and
Page 119 and 120: 8 Social Correlates and Social Rein
Page 121 and 122: Altogether, 987 clients (610 of the
Page 123 and 124: 9 Drug-Related Crime, Prevention of
Page 125 and 126: Table 9-2: Number of persons arrest
Page 127 and 128: Figure 9-1: Total number of persons
Page 129 and 130: Table 9-7: Sentences and other meas
Page 131 and 132: Table 9-9: Drug-related misdemeanou
Page 133 and 134: in custody, and 8 being the inmates
Page 135 and 136: (approximately 0.5%). However, only
Page 137 and 138: Table 9-15: NGOs providing drug ser
Page 139 and 140: Supported by the National Focal Poi
Page 141 and 142: was rather bizarre. For example, th
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conduct research in the area of pen
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Republic for the Period 2011-2012 f
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departments) or by the external pro
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more than 10 clients, etc. This is
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12 Drug Users with Children The aim
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Childbirth and the National Registe
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Table 12-2: Total number of mothers
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(diagnostic institutions), and reha
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12.3.2 Helping Services Help to chi
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13 Cross-border Travel, Drug Use, a
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ethnic minorities in the Czech Repu
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LIST OF TABLES Table 1-1: Overview
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Table 9-10: Criminal offences commi
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SELECTED DRUG-RELATED WEB PAGES ON
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2005-2009 National Strategy - Natio
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ministry, 18, 41, 42, 115 ministry
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Generální ředitelství Vězeňsk
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Mravčík, V., Zábranský, T., Kor
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Policie ČR (2011) Statistické př
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Van den Berg, C., Smit, C., Van Bru
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