Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Thomas and colleagues1 present the results of 9 years of follow-up in
a cohort of injection-drug users with hepatitis C virus (HCV) infection. The
primary outcome measures were viral clearance and end-stage liver disease
(ESLD). Since injection drug use now accounts for 60% of cases of new HCV
infections in the United States,2 this work is a valuable prospective
study of a high-risk population in which the natural history of infection
has great public health consequences. The design avoids the referral bias
that limits the validity of retrospective studies, and the study population
is demographically distinct from previous study cohorts, which have tended
to be older and sicker (such as transfusion-infected persons3)
or younger and healthier (such as immune globulin recipients4).
Nonetheless, these data do not answer several important questions.
Behrman AJ. Long-term Prognosis of Hepatitis C Virus Infection. JAMA. 2000;284(20):2592. doi:10.1001/jama.284.20.2591