Pubdate: Mon, 27 Sept 1999 Source: San Francisco Chronicle (CA) Copyright: 1999 San Francisco Chronicle Contact: http://www.sfgate.com/chronicle/ Forum: http://www.sfgate.com/conferences/ 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. - --- MAP posted-by: Derek Rea