Hepatitis C in methadone maintenance patients: Prevalence and public policy implications

Objective: This study measured the extent and examined implications of hepa titis C (HCV) infection in a methadone maintenance treatment (MMT) populati on. Method: Four hundred and sixty patients were tested for HCV-Ab, hepatic enz ymes and bilirubin, HCV-RNA, and hepatitis B antibody. Results: Overall, 87% of this population had evidence of HCV-Ab. Among drug injectors (IDU), 96% were I-ICV-Ab positive. Among a subset of Laotian opi um-smoking patients prevalence was only 11%. Sixty-two percent of patients with HCV-Ab had detectable HCV-RNA. Only 41% had elevated hepatic enzymes, and 5% had elevated bilirubin levels. All age groups were equally infected. Systemic problems in screening and treating HCV in drug users were identif ied. Conclusion: HCV infection poses significant long-term health risks for this population. Harm reduction interventions aimed at reducing transmission of HCV and other needle-related infectious disease deserves more consideratio n.