%0 Journal Article
%T Triangular Clinics: The Way of The Future
%A Seyed-Moayed Alavian
%J Hepatitis Monthly
%D 2005
%I Kowsar Corporation
%X Hepatitis C is not just a blood-borne disease, but a global threat, socially andeconomically. Every year, thousands of articles are written on this subject emphasizing the importance of urgent global efforts in reducing its incidence. World Health Organization (WHO) estimations suggest that up to 3% of the world's population (170 million) have been infected with HCV(1). About 85 percent of people with acute hepatitis C develop a chronic infection, an insidious disease whose barely discernible symptoms can mask progressive injury to liver cells over 2 to 4 decades. It is now the leading cause of liver cancer and results in more liver transplants than any other disease(2). Furthermore, injecting drug use (IDU) has been found the most common cause of HCV infection. IDUs contract hepatitis C by sharing contaminated needles and other drug injection paraphernalia. One recent study found that 64.7 percent of IDUs who had been injecting for 1 year or less were already infected with the virus. Overall prevalence of HCV was 76.5 percent among IDUs who had been injecting drugs for 6 years or less(2). Recently, HCV infection has drawn great attention due to similar risk factors and coinfectivity with human immunodeficiency virus (HIV) infection(1). Hepatitis C, HIV/AIDS, and hepatitisB share common risk factors for infection. IDUs have a high prevalence of co-infection with the viruses that cause these diseases. That is why it is important to test IDUs for all three viruses(2). About one quarter of HIV-infected persons in the United States are also infected with HCV(3). HIVHCV coinfection has been associated with higher titers of HCV, more rapid progression to HCVrelated liver disease, and an increased risk for HCVrelated cirrhosis of the liver. Because of this, HCV infection has been viewed as an opportunistic infection in HIV-infected persons and was included in the 1999 USPHS/IDSA Guidelines for the Prevention of Opportunistic Infections in PersonsInfected with Human Immunodeficiency Virus. It is not, however, considered an AIDS-defining illness. As highly active antiretroviral therapy (HAART) and prophylaxis of opportunistic infections increase the life span of persons living with HIV, HCVrelated liver disease has become a major cause of hospital admissions and deaths among HIV-infected persons(3). Nonetheless, the effects of HCV coinfection on HIV disease progression are less certain. Chronic HCV infection seems to accelerate the course of HIV disease, resulting in a more rapid clinical and immunological progression(4). However, the subject remains controversia
%U http://www.hepmon.com/pdf/Triangular_Clinics_The_Way_of_The_Future.pdf