Conclusions
In 2013, the typical veteran with chronic HCV was white, aged 60 years, and male, with a history of comorbidities, including hypertension, depression, and current or prior alcohol abuse. The proportion of veterans with advanced liver disease including cirrhosis (17%) and HCC (3%), has grown significantly over the past 10 years. By the end of 2013, almost 40,000 veterans had received antiviral therapy for HCV, more than 5,700 of whom had received DAAs. Overall SVR rates have been about 42% among those who were treated. Of veterans who are still potential treatment candidates, 85% are treatment-naive and about one-quarter have advanced liver disease.
Although HCV screening rates in veterans are higher than reported in other health care settings, particularly among those in the critical 1945-1965 birth cohort (65% screening rate), substantial numbers of veterans still require testing. The burden of disease, the lack of specialists, the ease and tolerability of new HCV antiviral medications, and the interplay of HCV with other traditional primary care efforts underly an increased role for PCPs in the care of veterans with HCV. Together, this information helps to construct a view of historical, current, and future HCV care in veterans.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patient.