SHARING A NEEDLE RISKS MORE THAN AIDS

Hepatitis also spreads among drug addicts David Perlman, Chronicle
Science Editor

Despite the success of needle exchange programs in preventing the
spread of AIDS among injection-drug users, a new epidemic is emerging
to threaten addicts with still another deadly disease.

Researchers call the problem ``co-infection,'' but to addicts on the
streets and in the hidden alleys of major cities, it means that when
they share needles they risk not only AIDS but also infection with the
hepatitis C virus that causes chronic liver disease and fatal liver
cancer.

One of the earliest volunteer needle exchange efforts took place in
Vancouver, British Columbia, with vans roving inner-city streets each
night to bring clean needles and disinfectant to addicts wherever they
gathered.

When some of the addicts who declined the free needles developed AIDS
and sought treatment at the city's clinics, doctors who examined them
began observing an increase in positive blood tests for the hepatitis
C virus.

Injection Users' High Risk

In February, a team at St. Paul's Hospital in Vancouver opened a new
AIDS clinic specifically aimed at testing and treating patients who
are co-infected with HIV, the AIDS virus, and the hepatitis C virus.

The clinic is keeping long-term records of its patients, and some of
its latest findings were reported in San Francisco yesterday by Dr.
Dwight Ferris of Vancouver at the opening of a meeting in Moscone
Center called the Interscience Conference on Antimicrobial Agents and
Chemotherapy -- known to researchers as ICAAC.

In a study comparing drug users who came to the clinic and patients
who did not inject drugs -- all of whom were infected by the AIDS
virus -- clinic doctors found that 100 percent of the injection drug
users were also infected with the hepatitis C virus, while the virus
showed up in only 25 percent of those who did not inject drugs.

The injection drug users were also much less likely than the nonusers
to be taking new and powerful combinations of anti-AIDS medicines
known as highly active anti-retroviral therapy, Ferris reported.

The Alcohol Factor

Heavy alcohol drinking was also a distinctive characteristic of the
injection drug users who were co-infected with hepatitis C.

The urgent need now, Ferris said, is to develop ``a new standard of
care for HIV-infected individuals with hepatitis,'' as well as more
effective strategies for treating the alcohol abusers among them whose
combination of afflictions poses a formidable challenge for all AIDS
caregivers.

The huge ICAAC meeting, attended by more than 16,000 medical
researchers, drug company representatives and health care workers, is
expected to fill Moscone Center's immense exhibit halls and conference
rooms through Wednesday.