3375662_yjbm_85_2_249_g03I have counseled Vets to use a double-edged sword to prove service connection when filing- i.e. genotype and biopsy. Forty years ago, genotypes had a distinct geographical distribution. A good biopsy-preferably based on the Metavir scale -shows the approximate age of the disease and it’s linear progression. 

Using these two tools and a nexus from a gastroenterologist who succinctly connects the dots for the VA, it’s a virtually bulletproof combination to prove service connection. Using the genotype is very useful as the geographic distribution forty or fifty years ago was a unique, signature footprint.

Here, the Vet is pointing to genotype 2b as being proof of contraction during his service in Germany. Unfortunately, he would most likely have had 1B were it indeed from die Stricherin. On the other hand, if he had service in Japan, Korea or Okinawa he would indeed have been infected with 2b (or 2a)  had he contracted the local, homegrown version.

He does have some self-confessed ‘Imperial Entanglements’ of snorting the white lady and post-service tattoos. These could easily be overcome by a preponderance of the risk factors and evidence (genotype and disease progression)  pointing to service connection as the greatest risk. Having that nexus and a clear, concise rationale that precludes speculation are how these are won.

Johhny Reb was on the right track but went off the reservation with the 2b theory. As I have taught here, it is viable and persuasive evidence when correctly used. I won based on mine being 3a- indigenous almost exclusively at the time to the Indochinese Peninsula and also, of all places, Australia. Since we know it didn’t swim there, I suspect R&R played a great role in its migration.

duel-headerSince he didn’t play the hole card with the biopsy results, and VA noticeably did not volunteer any input in that regard, Johnboy lost. This is a game of inches and Johnny missed by a large margin. I suspect the American Legion was not there to hold his coat during the dual or perform the gentlemanly function of being his second.

Winning VA HCV claims absent any defining “aha” moment like a diagnosis of Hepatitis during service isn’t impossible. Success depends exclusively on risk and exposure to same. Having the correct geographical genotype and a Stage four biopsy simply cements the theory of it’s origin and age. As usual, the third leg of the stool is the nexus but that becomes academic after your evidence proves that the genotype theory and relative age are sound.

About asknod

VA claims blogger
This entry was posted in BvA HCV decisions, HCV Health, HCV Risks (documented), IMOs/IMEs and tagged , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.


  1. woodguy11 says:

    I have 1a geno and if this is correct I got a transplant 2007 end stage which would be 37 years .can they tell how old it is by liver biopsy? just got the med paper work from 1st biopsy in 2005. I don;t know what to look for in medical terms. is it called etioligy? thanx

    • asknod says:

      Liver necrosis (cirrhosis or fibrosis) is measured in stages of destruction. Google Child, Pugh’s, and Metavir scales. Metavir is the most widely used and is divided into 4 stages of necrosis and degree of activity. The stage ratings are usually ten years in duration. The Grade ratings is a measurement of how much damage is occurring at the moment. I give and example. I know I got mine Sept. 15th, 1970. I’m at late stage grade 3/early 4 . My grade of activity has always been 3. That’s 44 years but I recognized the damage accruing by 1994-98. I quit smoking and drinking and attribute that to why my advance slowed down. I’m feet dry now since Dec.7th, 2014.

  2. SPrice says:

    Progression is not linear. It’s slower in the first stages and happens faster in the last stages. Plus, alcohol doubles the rate of progression.

    • asknod says:

      Not in all cases. My progression was linear from 1970 to 2007 including a stint in ETOH land from 82-93 that would make a sailor proud. The progression stalled and remains on the cusp of Stage 4 as shown by biopsy. By rights, with my AIH and 2-year exposure to Agent Orange, I should have HCC and be in txplant land as I’m @ 44 years from date of infection.

    • woodguy11 says:

      I don’t know I drank pretty heavy for 10 years after discharge and I am at 37 years @ transplant. It was just beer. I quit drinking after 10 years it got to me mentally so I turned myself in to rehab and quit

  3. SPrice says:

    Regarding genotype 3…. Let’s not forget that many Australians volunteered and went to Vietnam with you.

    In 1998, the Australian government conducted the Vietnam Veterans’ Health Study which showed, beyond doubt, that veterans, their spouses and their children suffer from a range of illnesses at rates unheard of until then. Examples include leukemia and prostate cancer (300% higher of the expected rate), cancer of the colon (350%) male breast cancer (2500%), ischaemic heart disease (200%), diabetes (200%) . Incidence of spina bifida in children of Vietnam veterans is more than 1000% of the expected rate, cleft lip or palate over 400% higher, absent body parts 1000% higher and combined cases of accident and suicide (combined because some suicides are reported as accidents) 250%, motor neuron disease (6000%). Spouses aso had very high rates of stress, anxiety, and depression.

    HOWEVER….the issue of hepatitis C has not been explored. If they ever do, one thing will complicate matters. Aussies didn’t use jetguns.

    • woodguy11 says:

      hey I thank you guys for helping us I liked the aussies and when r and r came we went to austrailia where round eyed women lived and they were waiting for us at the terminal man that was great. hope you are doing well mate

  4. woodguy11 says:

    where do you suppose the type 1 came from.? genotype 1

    • asknod says:

      1a is American and the predominant strain in NOrth America. 1b= Europe. 2a&b = Japan/Korea; 3a =Indochina. All these were the case in the 60s-70s. They have migrated around now.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.