stars & disk

Bird & Flags

text

ABOUT HEPATITIS C

• The symptoms of hepatitis C infection

are often very mild. Most people can carry 

the virus for years and will not notice any 

symptoms. The most common symptoms 

are vague abdominal discomfort, fatigue, 

and joint pains. 

• Over time, HCV can cause other health

problems, such as cirrhosis and liver 

cancer. Because the virus stays in the body, 

an infected person can give hepatitis C to 

someone else.

• People at risk for hepatitis C should

consider getting tested. Blood tests are 

required to determine if HCV is present in 

the body.

• As of March 2016, VA had treated more

than 76,000 Veterans infected with 

hepatitis C and approximately 60,000 had 

been cured. Since the beginning of 2014 

and as of March 2016, more than 42,000 

patients had been treated with new, highly 

effective antiviral medications.

• In fiscal year 2015, VA allocated $696

million for new hepatitis C drugs, which is 

17 percent of VA’s total pharmacy budget.

VA RESEARCH ON HEPATITIS C: 

OVERVIEW

• VA research on hepatitis C includes

clinical trials of treatments, epidemiologic 

studies, investigations of the biological 

mechanisms of infection, and studies 

on identifying and removing barriers to 

treatment.

• Some VA researchers are working on

projects to improve screening and testing 

methods for HCV. Others are working to 

improve the assessment and treatment 

of patients traditionally excluded from 

hepatitis C treatment, including those 

with mental illness, substance abuse, or 

who also are infected with the human 

immunodeficiency virus (HIV), the virus 

that causes AIDS. 

• In addition, VA researchers are

developing and disseminating models of 

interdisciplinary care to optimize treatment 

and clinical standards for treating patients 

at all stages of HCV infection.

SELECTED MILESTONES AND 

MA JOR EVENTS 

2011 – Established the VA National 

Hepatitis C program (now the National 

Viral Hepatitis Program) within VA’s Office 

of Public Health

2013 – Determined that patients with both 

anemia and the HCV virus can benefit from 

intensive treatment for the virus

2015 – Learned that cure rates from new 

HCV treatments were much better than 

previous treatments, but not as good as 

rates reported in clinical trials

2015 – Developed a new model to help 

identify which patients chronically 

identified with HCV have the greatest need 

for new antiviral drugs

2016 – Found that patients with HCV 

infections are at increased risk of 

developing osteoporosis and fractures

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• A new model uses routine laboratory

tests and machine-learning methods

to help identify which patients clinically 

identified with HCV have the greatest 

need for new antiviral drugs. According 

to researchers from the VA Ann Arbor 

Healthcare System and the University 

of Michigan, hepatitis will remain stable 

VA research on 

HEPATITIS C

Hepatitis C, caused by the hepatitis C virus (HCV), is a 

condition marked by inflammation of the liver. HCV is spread 

through contact with infected blood or contaminated 

IV needles, razors, tattoo tools, or other items.

(Continued on back)

Photo: ©iStock/ Thomas_EyeDesign
stars & disk

Bird & Flags

text

As of March 2016, VA had treated 

more than 76,000 Veterans infected 

with hepatitis C, and approximately 

60,000 had been cured.

without treatment, perhaps for many 

years, in most patients. One-third of 

patients, however, are at high risk of 

complications and need immediate 

care to prevent the virus from causing 

further liver damage. The test will 

identify these patients. (Hepatology, 

June 2015)

• Statins improved outcomes 

among Veterans receiving antiviral 

treatment for hepatitis C. Researchers 

from the VA Pittsburgh Healthcare 

System found that those who used 

statins were significantly more likely to 

have a sustained response to antiviral 

therapy, compared with those who 

did not (39 percent versus 33 percent.) 

Statin users were also less likely to 

progress to cirrhosis (17 percent 

versus 25 percent) or to develop liver 

cancer (1.2 percent versus 2.6 percent). 

(Hepatology, August 2015)

• Cure rates range from 67 to 79 

percent for patients using sovosbuvir 

(sold as Sovaldi), a new drug for the 

treatment of hepatitis C, according to an 

observational study of more than 4,000 

Veterans conducted by the VA Palo Alto 

Health Care System. These cure rates are 

far better than those of previous HCV 

treatments, but fall short of the rates 

seen in clinical trials of sovosbuvir. A 

newer drug, Harvoni, was not include 

in the Palo Alto trial, as the drug was 

not FDA-approved when the trial was 

conducted. (Alimentary Pharmacology 

and Therapeutics, September 2015)

• Veterans with substance use or 

psychiatric disorders and HCV 

infections who received care that fully 

integrated support for their mental 

health issues and their hepatitis C 

infection under the supervision of a care 

manager were more likely to receive 

antiviral therapy than those whose 

care was not integrated. Researchers 

at the VA San Diego Healthcare System 

also found that Veterans with care 

managers were also more likely to 

successfully complete antiviral therapy 

and have undetectable virus loads at 

its completion, compared to those who 

received usual methods of care. (Clinical 

Gastroenterology and Hepatology,

November 2015) 

• Veterans with HCV and liver 

cirrhosis are significantly less likely 

to die or to progress to a stage in the 

disease called decompensated cirrhosis 

if they use statins to control blood 

cholesterol. According to a team from 

the VA Connecticut Healthcare System 

and Yale University, until randomized 

controlled trials are conducted, statins 

cannot be widely recommended for 

all people with HCV and cirrhosis, but 

patients with HCV who would require 

statins for other health issues such as 

high cholesterol should be prescribed 

those drugs. (Gastroenterology, 

February 2016) 

• Patients with HCV infections are 

at increased risk of developing 

osteoporosis and bone fractures, 

and the risk is greatest for patients who 

have both HIV (the virus that causes 

AIDS) and HCV infections. Researchers 

at the VA North Texas Health Care 

System and the University of Texas 

Southwestern found that patients with 

HIV and HCV have a threefold greater 

risk of developing fractures compared 

with people who have neither infection, 

and that those with both infections 

also have significant additional risk 

compared to patients who are only 

infected with HIV. (Current Opinion in HIV 

and AIDS, May 2016)

For more information on VA studies 

on hepatitis C and other key topics 

relating to Veterans’ health, please 

visit www.research.va.gov/topics

HEPATITIS C

Updated September 2016 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics