Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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An estimated 15%-40% of incarcerated persons in the United States are infected with hepatitis C virus (HCV). Approximately 1.4 million HCV-infected persons pass through the corrections system annually, accounting for one-third of the total number of HCV-infected persons in the United States. ⋯ Research on the implementation of cost-effective HCV screening, prevention, and treatment programs among incarcerated persons is essential. Testing, education, and, when appropriate, treatment of prisoners should be a cornerstone of the public health response to the hepatitis C epidemic in the United States.
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An estimated 210,000 people were living with hepatitis C virus (HCV) infection in Australia at the end of 2001, and the number of people developing cirrhosis was projected to increase 4-fold by 2020. Eighty percent of prevalent and 90% of incident HCV infections are related to injection drug use. Current injection drug use was an exclusion criterion for access to government-funded treatment for HCV infection until May 2001. ⋯ Treatment outcomes among IDUs with chronic HCV infection treated at 2 public hospital-based hepatitis clinics are presented. These data demonstrate that IDUs who continue to inject infrequently during treatment for HCV infection can achieve a sustained virological response. Further studies are under way to examine outcomes of treatment for HCV among clients undergoing treatment for drug dependency who have chronic HCV infection and among current IDUs with acute and newly acquired HCV infection.
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Infection is the most common complication of chemotherapy-induced neutropenia. Bacterial infections predominate during the early stages of a neutropenic episode, whereas invasive fungal infections tend to occur later. The epidemiological pattern of bacterial infection continues to evolve globally and locally at the institutional level, as do patterns of susceptibility and resistance. ⋯ They also stress the increasing importance of prevention and control of infection and stewardship of antibiotics as strategies in the overall treatment of patients with febrile neutropenia. The recognition of a subset of low-risk patients with neutropenia has created new opportunities (e.g., outpatient and oral therapy) and new challenges (e.g., infrastructure, safety, and compliance). These challenges may be met, to some extent, by appropriately adapting national guidelines to local and institutional circumstances.