From Issue 8, Winter 2012 Public Health Matters Newsletter, Clinical Public Health, VHA Office of Public Health
Data from the VA’s National Clinical Case Registry for hepatitis C virus (HCV) confirm the burden of disease in the VA Health Care System and prepare providers for the road ahead as deaths from chronic HCV are expected to rise sharply during the next 10 years.”
At ASKNOD, we know that–
“…Most Veterans with chronic HCV in VA care in recent years were likely infected during the Vietnam War era (1964–1975). Given the natural history of chronic HCV, one would expect to see increasing numbers of conditions related to progression of liver disease, including cirrhosis and HCC.”
Doing some easy subtraction–Veterans who die of diseases from chronic HCV in 2020, and were infected in 1964, will have had HCV for 56 years according to the natural history of the disease.
The VA (RO and BVA) and Congress (both parties) know this but shamelessly play games with veterans.
Since most veterans are in private health care (about 75%) is it safe to crudely estimate over 600,000 veterans are being treated for HCV in private care?
A highly-cited government study of the general population, The Prevalence of Hepatitis C Virus Infection in the United States, 1999 through 2002 , has promoted the myth that IDU was the main cause of HCV-infections in the 45-65 age birth cohort because 46.6% of those in the study reported IDU at some point in the past. Although they did note that over 60% of HCV-study participants received transfusions before 1992, by the questions asked, and more to the point, didn’t ask about medical interventions. It sure looks and sounds pretty but it’s a lousy biased study!
Miriam J. Alter, PhD., is one of the influential authors. Her name (and voice in online HCV lectures) surfaces again and again but unfortunately, she’s a researcher with blinders on. (She is not related to Harvey Alter, a prominent HCV scientist.) Both the Alters are mentioned in this 20-year-old article: http://www.nytimes.com/1993/01/19/science/mysterious-epidemic-of-furtive-liver-virus.html?pagewanted=all&src=pm
This article references studies that might help track down the origin of HCV in American troops in the ’40s or earlier.
Update: I changed IVDU to IDU because according to one physician (Pepin, J.) IDU is an abbreviation that can refer to an injection drug user or intravenous drug user.