The Department of Veterans Affairs (VA) has reached a significant milestone, having cured more than 100,000 Veterans of chronic hepatitis C virus infection (HCV), establishing VA as a global leader in the diagnosis and treatment of HCV.
HCV infection can lead to advanced liver disease (ALD), liver cancer and early death. Curing HCV can prevent the development or progression of ALD, cutting death rates by up to 50 percent. Until recently, HCV treatment required medications to be taken daily by mouth and weekly by injection for up to a year, with cure rates as low as 35 percent. Additionally, this treatment had disabling medical and psychiatric side effects, which caused over half of patients to stop treatment prematurely.
In early 2014, highly effective, less toxic, all-oral, direct-acting antivirals (DAAs) became available for HCV treatment. These new drugs have few and less severe side effects and can be given as one pill a day for as little as eight weeks, revolutionizing HCV treatment. VA adopted use of these new medications within days of FDA approval.
Through Veteran advocacy, VA leadership and the support of Congress, VA implemented an aggressive program to treat Veterans with HCV who were both willing and able to be treated. This included extensive outreach to all Veterans in VA known to have HCV infection, and increased testing of those at highest risk for HCV. At the end of 2018, almost 85 percent of Veterans at increased risk for HCV had been tested, compared to 50 percent for the general U.S. population.
At the peak of this effort to rapidly deploy DAAs, VA was starting a Veteran on HCV treatment every 72 seconds on a typical workday; a rate of almost 2,000 new treatments each week. Currently, fewer than 25,000 Veterans in VA care remain to be treated. Because of this historic effort, Veterans cured of HCV are estimated to be 72 percent less likely to develop liver cancer.