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Volume 345:211-214 July 19, 2001 Number 3
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Is It Justifiable to Withhold Treatment for Hepatitis C from Illicit-Drug Users?

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Approximately 3 million Americans are thought to be infected with hepatitis C virus (HCV).1 HCV causes chronic infection in about 85 percent of infected persons, and cirrhosis may develop in as many as 20 percent of those with chronic infection.2 HCV infection results in 8000 to 10,000 deaths annually and is the most common reason for liver transplantation in the United States. The rates of morbidity and mortality from HCV infection are increasing, and this trend is expected to continue in the coming decades.1 Treatment with interferon, with or without ribavirin, for 6 to 12 months results in viral clearance . . . [Full Text of this Article]

Arguments for Withholding Treatment from Illicit-Drug Users

Adherence to Treatment

Side Effects of Treatment

Reinfection with HCV

Timing of Treatment

Medical and Public Health Practices

An Alternative Policy

Conclusions

Address reprint requests to Dr. Edlin at the Urban Health Study, Institute for Health Policy Studies, University of California, San Francisco, 3180 18th St., Suite 302, San Francisco, CA 94110, or at bredlin@itsa.ucsf.edu.

References


Related Letters:

Interferon Alfa–Induced Adverse Effects in Patients with a Psychiatric Diagnosis
Pariante C. M., Landau S., Carpiniello B., the Cagliari Group
Extract | Full Text | PDF  
N Engl J Med 2002; 347:148-149, Jul 11, 2002. Correspondence

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