San Francisco VA Health Care System
New and Improved Treatments for Hepatitis C
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 higher than 90 percent for most people.
“Prior available HCV treatments were lengthy, had serious side effects, and didn’t work very well,” says George Herzog, clinical nurse specialist and Liver Clinic care coordinator 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 have focused on patients with significant scarring of the liver or early cirrhosis for HCV treatment. In contrast, SFVAHCS researchers contributed to research that shows the optimal time for treatment should be earlier. National guidelines have now evolved to allow treatment for everyone with HCV. The SFVAHCS encourages all Veteran patients with HCV to seek treatment.
“Curing the Hepatitis C virus stops ongoing damage to liver cells,” Herzog said. “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, 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 patients. 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 and encourage Veterans to seek treatment.
“Our message to Veterans is, get tested and get treated,” Herzog said. “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."
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Where to get help
Veterans enrolled in VA health care at the SFVAHCS can call the San Francisco VA Medical Center at 415-221-4810, ext. 2-4771, and ask to be screened for HCV. Patients at our six VA community clinics can call their primary care provider and request a lab test for HCV. For community clinic patients, liver specialists conduct visits from SFVAMC using Video Telehealth through a novel program called SCAN-ECHO, that assists local physicians in caring for patients with HCV. Medication and lab tests are available locally at the clinics.
For more HCV information, visit www.hepatitis.va.gov.