HEPATITIS EPIDEMIC

Editor -- Regarding your September 27 article on hepatitis C among
injection drug users, San Francisco is also in the midst of a hepatitis C
epidemic. Upwards of 90 percent of injection drug users here are infected
with the hepatitis C virus.

Furthermore, our studies show that as many as 95 percent of injection drug
users were infected as far back as 1987. Most of these people started
injecting in the 1970s and are probably well into their third decade of
infection. They may soon, if they are not already, be suffering from
end-stage liver diseases such as cirrhosis or liver cancer. The burden of
disease is potentially staggering, given that there are an estimated 15,000
injection drug users in our city, of whom 13,000 may be infected.

To effectively confront this problem, we must continue to prevent new IICV
infections through needle exchange and distribution programs. We must also
provide hepatitis C education and medical care that specifically address
the needs of injection drug users, the group of people most affected by
this epidemic.

JENNIFER LORVICK

KAREN H. SEAL, M.D.

Urban Health Study UC San Francisco