Hepatitis C Awareness
San Francisco VA Health Care System Liver Clinic. Front row, left to right: Helen Yee, PharmD; Heather Freasier, M.S., R.D.; Phyllis Tien, M.D. Back row, left to right: Erica Trimble, NP; William Hua, Ph.D.; Alexander Monto, M.D.; George Herzog, CNS.
May is Hepatitis Awareness Month and San Francisco VA Health Care System is getting the word out about hepatitis C testing and treatment. Hepatitis C is a disease that affects the liver. Veterans are at higher risk for Hepatitis C and testing is recommended for Vietnam Era Veterans and those born between 1945 and 1965.
Since 2013, Hepatitis C Virus (HCV) treatment has changed significantly with the approval of new agents or fixed drug combinations. These treatments are far better than any previously available, with cure rates of over 90 percent for most people.
“Prior available HCV treatments were lengthy, had serious side effects, and didn’t work very well,” says George Herzog, a clinical nurse specialist and a care coordinator at the Liver Clinic at the San Francisco VA Health Care System (SFVAHCS). “In comparison, the new HCV treatments consist of pills only, cause minimal side effects, and have much better cure rates. The length of HCV treatment has decreased to 12 weeks for most people.”
Because of the high cost of these new drugs and the fact that liver damage progresses slowly in many patients with HCV, many organizations targeted patients for HCV treatment only after significant scarring of the liver or early cirrhosis had occurred. In contrast, SFVAHCS researchers contributed to work showing that the optimal time of treatment should be earlier. National guidelines have now evolved to allow treatment for everyone with HCV, and SFVAHCS encourages all Veterans with HCV to come for treatment.
“Curing the Hepatitis C virus stops ongoing damage to liver cells,” says Herzog. “Most people with Hepatitis C don’t have any symptoms. The only way to know if you have Hepatitis C is to request a blood test.”
Nationwide, the VA leads the country in HCV screening, testing, treatment, research and prevention. The SFVAHCS Liver Clinic team is a significant contributor and consultant for the VA’s National Hepatitis C Resource Center, where national educational products on HCV are developed, including treatment guidelines and clinical tools for providers, and medication handouts for Veterans. SFVAHCS investigators conduct research in partnership with the University of California, San Francisco, and other VAs around the country, fostering excellence and scientific collaboration among its members. The SFVAHCS Liver Clinic team also includes a hepatologist, a nurse practitioner, a clinical pharmacist and a psychologist. They hold clinics on multiple days of the week, including drop-in follow-up clinics. The SFVAHCS Infectious Disease Clinic also has a team of specialists that provides specialized care for Veterans with HIV and HCV co-infection, because of complex drug-to-drug interactions that can occur with the combination of HIV and Hepatitis C treatments. The clinics work closely together to determine the optimal HCV treatment regimen for each Veteran.
Veterans enrolled in VA health care at the San Francisco VA Medical Center (SFVAMC) can call Herzog at (415) 221-4810, ext. 2-4771 and ask to be screened for HCV. Veterans at our six VA community clinics can call their primary care provider and request a lab test for HCV. For community clinic Veterans, liver specialists conduct visits from SFVAMC using Video Telehealth through a novel program called SCAN-ECHO, which assists local physicians in caring for Veterans with HCV. Medication and lab tests are available locally at the clinics.
“Our message to Veterans is, get tested and get treated,” says Herzog. “If you haven’t been tested for Hepatitis C, call me and I can arrange for you to be tested. We want to make your access to care as easy as possible.”
For more information about HCV, visit www.hepatitis.va.gov
