UCSF REJECTS U.S. HEPATITIS C POLICY

Report Urges Treatment For Illicit Drug Users

SAN FRANCISCO -- University of California, San Francisco, researchers
have released a report recommending that illicit drug users infected
with the hepatitis C virus be eligible for treatment. The recommendation
goes against federal guidelines set in 1997.

The article, published Thursday in the New England Journal of Medicine,
was written by seven UCSF scientists in conjunction with a group of 38
national and international experts, a university spokesman said.

Intravenous drug users are the main source of transmission of the
hepatitis C virus in the United States. The virus is easily spread by
contaminated needles. The report argues that spread of the disease
cannot be controlled without treating drug users.

"Controlling hepatitis C will require providing treatment to people who
use illegal drugs," said Dr. Brian Edlin, the article's lead author. "We
believe that when treatment is guided by evidence, tolerance and
compassion, this can be done."

The report refutes previous arguments against treating drug users,
including concern that they will not finish treatment, preference that
they receive substance abuse treatment first and fear that they will
become infected with the virus again.

Researchers note that many patients who do not use drugs also fail to
complete or comply with treatment for many medical conditions, such as
heart disease and diabetes.

"If poor adherence were a reason to withhold treatment, most medical
conditions would go untreated," Edlin said.

"A policy of deferring treatment indefinitely in patients who do not
have access to substance abuse treatment effectively abandons those most
affected by the hepatitis C epidemic," the report notes. "A
recommendation to withhold medical treatment from (illicit drug users)
raises questions about fairness and discrimination."

The authors recommend that treatment decisions for drug users be made
specific to the individual, based on mental health and risk of
depression, access to clean needles and syringes, knowledge of safe
injecting practices and the patient's willingness to remain on
medication.