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Vol. 12, No. 1, 2006
Issue release date: December 2005
Eur Addict Res 2006;12:12–19

Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia

Krupitsky E.M. · Zvartau E.E. · Lioznov D.A. · Tsoy M.V. · Egorova V.Y. · Belyaeva T.V. · Antonova T.V. · Brazhenko N.A. · Zagdyn Z.M. · Verbitskaya E.V. · Zorina Y. · Karandashova G.F. · Slavina T.Y. · Grinenko A.Y. · Samet J.H. · Woody G.E.
aScientific Research Center of Addiction and Psychopharmacology, St. Petersburg State Pavlov Medical University, St. Petersburg, Russia; bDepartment of Medicine, School of Medicine, Boston University, Boston, Mass., and cDepartment of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA

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The Russian health care system is organized around specific diseases, with relatively little focus on integration across specialties to address co-morbidities. This organizational structure presents new challenges in the context of the recent epidemics of injection drug use (IDU) and HIV. This paper uses existing and new data to examine the prevalence of reported new cases of drug dependence (heroin) and HIV over time as well as associations between drug dependence and alcoholism, hepatitis B and C, and tuberculosis in the City of St. Petersburg and the Leningrad region. We found a sharp rise in reported cases of IDU beginning in 1991 and continuing until 2002/2003, followed by a sharp rise in newly reported cases of HIV. These rises were followed by a drop in new cases of HIV and drug addiction in 2002/2003 and a drop in the proportion of HIV-positve individuals with IDU as a risk factor. Infection with hepatitis B and C were common, especially among injection drug users (38 and 85%, respectively), but also in alcoholics (7 and 14%). Tuberculosis was more common in alcoholics (53%) than in persons with alcoholism and drug dependence (10%), or with drug dependence alone (4%). Though these data have many limitations, they clearly demonstrate that drug dependence and/or alcoholism, HIV, hepatitis, and tuberculosis frequently co-occur in St. Petersburg and the Leningrad Region. Prevention and treatment services across medical specialties should be integrated to address the wide range of issues that are associated with these co-morbidities.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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    External Resources

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