Screening and Treating Veterans for Hepatitis C

By Debbie Gregory.

Veterans and organizations representing them have expressed considerable interest in the possible link between hepatitis C virus (HCV) infection and immunization with air-gun injectors or other military-related blood exposures, which were common during the Vietnam War, since transfusions were used in great numbers.

The virus also can be sexually transmitted or through intravenous drug use, which was also common in Vietnam.

The Department of Veterans Affairs has treated 65,000 veterans for the virus, but about 87,000 remain untreated and an additional 20,000 are undiagnosed.

VA officials are seeking $1.5 billion in the 2017 fiscal year to treat more veterans.

But the financial challenge is not near as great as the VA’s challenge in convincing veterans to be screened or treated for the virus. Some veterans distrust the VA, some are concerned with the stigma of hepatitis C and drug use, and some fear traditional drug treatment with severe side effects.

Some veterans who test positive for hepatitis C suffer from mental illness or substance abuse, and these issues can affect their reliability to show up for treatment.

According to Dr. David Ross, director of the VA’s hepatitis C program, “Historically, treatment rate has been low for two reasons. One, standard treatments have been awful. The drugs are horrible and don’t work that well. Secondly, a lot of patients have conditions such as depression or substance abuse problems that get in the way of treatment.”

The VA has screened 73 percent of Vietnam War-era veterans enrolled in the VA system. There are about 700,000 veterans born between 1945 and 1965 who still must be screened.

The VA has started to reach out to veterans with hepatitis C to inform them that they have the resources to test and treat them, Ross said.

“Facilities have for months now been taking lists and just calling people and saying, ‘Would you like to come in?’ ” he said. “We’re trying to let people know we’re very committed to doing this, and we have the resources to do it.”

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