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INTERVIEW-Ignoring Hep C in Thai HIV-positive drug users helps HIV spread

Source: Thomson Reuters Foundation - Fri, 6 Aug 2010 09:06 GMT
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BANGKOK (AlertNet) - Thailand's failure to treat the Hepatitis C virus in HIV-positive injecting drug users means that the human immunodeficiency virus remains highly infectious in this group and is more likely to spread to other people, an activist said.

There are roughly between 30,000 and 60,000 injecting drug users in Thailand living with either HIV or AIDS caused by the virus, said Karyn Kaplan who heads Thai AIDS Treatment Action Group.

About 90 percent of such drug users in Thailand also carry the Hepatitis C virus because both viruses are blood-borne and can be transmitted through shared needles and other equipment, even cotton swabs.

The Hepatitis C virus can be cured but if untreated, it develops into a potentially deadly liver disease. At that point anti-retroviral therapy for HIV, which also significantly reduces its infectiousness, stops working, Kaplan said.

"So IDUs (injecting drug users) will continue to be infectious, which is of importance from a national perspective in that (the government) will not be able to control HIV in this population," she told AlertNet.

Thailand's public health service does not cover treatment for the Hepatitis C virus and few people can pay for the costly therapy at a private clinic, according to a recent report by Kaplan's organisation.

Moreover, many Thai doctors would refuse treatment to former or current injecting drug users because they think these patients cannot adhere to treatment regimens, the report said.

Kaplan added that there is a widely held view in Thailand that "this population, their health and lives are less important than other populations or not important at all" even in spite of their role in the spread of HIV.

To limit the spread of the Hepatitis C virus, Thai AIDS Treatment Action Group is calling for several changes in Thailand's health policies.

"The best way to prevent a blood-borne disease in an IDU is to provide them with the tool that they need, which is a clean needle. The government still does not endorse access to clean injecting equipment for people who use drugs," Kaplan said.

The group's other recommendations include the universal provision of free testing and treatment for the virus.

Thailand has been widely praised for its work in containing HIV. The number of new infections fell to 18,000 in 2005 from a peak of around 140,000 a year in 1991, according to UNAIDS. This was achieved mainly because men used condoms more and visited brothels less.

(Additional reporting by Olesya Dmitracova in London)

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