Hepatitis C and HIV are very different diseases and raise very distinct public health, medical and management issues for VA.
- Dr. Thomas Garthwaite
 

The Department of Veterans Affairs recently moved its national hepatitis C program to the Office of Public Health and Environmental Hazards. Lawrence Deyton, M.D., director of the VA's AIDS program, will continue to oversee veterans infected with HIV while serving as the new director of its hepatitis C program.

"Moving the hepatitis C program is just the first step in expanding our commitment to identify and treat all veterans with the disease," said Dr. Thomas Garthwaite, the VA's under secretary for health. "VA screens, tests and treats more people with hepatitis C than anyone else in the country."

"Hepatitis C and HIV are very different diseases and raise very distinct public health, medical and management issues for VA," said Deyton. "We have learned important lessons in dealing with HIV as a public health concern that can be applied to hepatitis C. VA's HIV program has an excellent track record and is seen as a leader in HIV education and care. We plan to use the best from that program to build on VA's first-rate hepatitis C program."

Chronic Diseases

Both hepatitis C and the human immunodeficiency virus (HIV) that causes AIDS are chronic diseases caused by blood-borne viruses. Hepatitis C affects four to five times as many Americans as HIV, according to the federal Centers for Disease Control.

The VA sees approximately 19,000 veterans who have tested positive for HIV and nearly 70,000 who have tested positive for hepatitis C. Both diseases are treated with combination drug therapies. Without treatment, the diseases can be fatal.

Since taking on hepatitis C in 1992, the VA has established two Centers of Excellence at the Miami and San Francisco VA medical centers, cooperated in veteran outreach partnerships, conducted extensive research and sponsored educational conferences.

The VA also monitors the hepatitis C epidemic and the effectiveness of its response through a national registry. Nearly 113,000 veterans were tested during 1998, the registry's first year of operation. About 213,000 were tested from January 1999 to March 2000.

"My plans are to set up a new strategic health care group that will include both hepatitis C and HIV," said Garthwaite. "By combining the best of both programs and placing them under the same management team, these important, complex diseases will get the full attention and resources they deserve and, most importantly, our veterans deserve."

"For both hepatitis C and HIV, the veterans who are at risk need to be identified and tested," said Deyton. "Preventing new infections must be a priority, and clinical providers must be educated about new research findings that have an impact on clinical care."