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Reuters Medical News

Hepatitis C Virus Infection Common Among US Veterans

DALLAS, Nov. 11 (Reuters Health) - Among veterans who received routine outpatient care at San Francisco Veterans Affairs Medical Center, the prevalence of hepatitis C virus (HCV) infection is 18.8%, according to the results of a recent screening study.

Dr. Teresa L. Wright and Megan E. Briggs reported the finding at the 50th annual meeting of the American Association for the Study of Liver Diseases.

The researchers screened 791 patients and also conducted brief interviews with each subject.  Dr. Wright reported that although the highest incidence of HCV was in Vietnam-era veterans, "...actual service in Vietnam was not identified as an independent risk factor for HCV."

In an interview with Reuters Health, Briggs said that the single greatest risk factor for HCV was intravenous drug abuse.  Briggs told meeting attendees that in addition to IV drug abuse, risk factors for HCV infection included tattooing, needle stick associated with service as a medical team member, and incarceration in jail lasting more than 48 hours.

Dr. Wright said that the Veterans Administration has developed preliminary plans to conduct a national study designed to determine the incidence of HCV among veterans.  She said that the study in San Francisco and another planned for Seattle will serve as pilot studies for the larger project.

Dr. Wright added that the Veterans Administration has approved the use of combination therapy with interferon and ribavirin for treatment of HCV-infected veterans.  Many veterans in the VA population "...do not make good candidates for this therapy because it has many side effects associated with it," she said. "But we know that we can get a 40% response with this therapy, so we think that it is important to identify those who are infected and offer treatment if appropriate."


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1: Am J Epidemiol. 2001 Apr 15;153(8):764-70./entrez/utils/lofref.fcgi?itool=AbstractPlus-def&PrId=3051&uid=11296148&db=pubmed&url=http://aje.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=11296148  Links
Comment in:
Am J Epidemiol. 2002 Apr 15;155(8):778-9.

Prevalence and incidence of hepatitis C virus infection in the US military: a seroepidemiologic survey of 21,000 troops.

Epidemiology Department, Naval Medical Research Center, Silver Spring, MD, USA.

Because of a high prevalence of hepatitis C virus (HCV) infection (10-20%) among veterans seeking care in Department of Veterans Affairs (VA) hospitals, current US military forces were evaluated for HCV infection. Banked serum samples were randomly selected from military personnel serving in 1997 and were tested for antibody to HCV (anti-HCV). Overall prevalence of anti-HCV among 10,000 active-duty personnel was 0.48% (5/1,000 troops); prevalence increased with age from 0.1% among military recruits and active-duty personnel aged <30 years to 3.0% among troops aged >/=40 years. Prevalence among 2,000 Reservists and active-duty troops was similar. Based on sequential serum samples from 7,368 active-duty personnel (34,020 person-years of observation), annual incidence of infection was 2/10,000. Of 81 HCV RNA-positive troops for whom genotype was determined, genotypes 1a (63%) and 1b (22%) predominated, as in the civilian population. These data indicate that HCV infection risk among current military forces is lower than in VA studies and the general civilian population aged <40 years. The low level of HCV infection may be attributed to infrequent injection drug use in the military due to mandatory testing for illicit drugs prior to induction and throughout military service.

PMID: 11296148 [PubMed - indexed for MEDLINE]