WASHINGTON, D.C. — To better address hepatitis C as a public health issue, as well as a medical condition, the Department of Veterans Affairs (VA) recently placed its national program under new management.
"VA screens, tests and treats more people with hepatitis C than anyone else in the country," said Dr. Thomas Garthwaite, VAs Under Secretary for Health. "Even so, VA continues to explore new ways to improve its hepatitis C initiatives. Moving the hepatitis C program to the Office of Public Health and Environmental Hazards is just the first step in expanding our commitment to identify and treat all veterans with the disease."
The new director of the hepatitis C program is Dr. Lawrence Deyton. Since arriving at VA, Deyton has been responsible for planning, coordinating, implementing and evaluating the care of veterans infected with the human immunodeficiency virus (HIV) that causes AIDS. Under his direction, VA provides more HIV services in the United States than any other health care system. Deyton will continue to direct the AIDS program, along with hepatitis C.
"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."
Since taking on hepatitis C in 1992, 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.
Additionally, VA monitors the hepatitis C epidemic and the effect of VA's response through a national registry. The first year the registry operated in 1998, nearly 113,000 veterans were tested. From January 1999 to March 2000, about 213,000 veterans were tested, almost double the number in the first year. These efforts will continue to expand under the new leadership.
"VA's multifaceted approach in the treatment of hepatitis C is unheralded," said Garthwaite. "My plans are to set up a new strategic health care group that will include both hepatitis C and HIV. 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."
Both hepatitis C and HIV are chronic diseases caused by blood-borne viruses. Hepatitis C affects four to five times as many Americans as HIV, according to the Centers for Disease Control (CDC). VA sees approximately 19,000 veterans who have tested positive for HIV and nearly 70,000 veterans who have tested positive for hepatitis C. Both diseases are treated with combination drug therapies, and without treatment the diseases can be fatal.
"VA is in an extraordinary position to continue to lead the way in this rapidly changing area of health care," said Deyton. "For both hepatitis C and HIV, the veterans who are at risk need to be identified and tested. Preventing new infections must be a priority, and clinical providers must be educated about new research findings that have an impact on clinical care.
"I am pleased that maintaining high-quality care for veterans with hepatitis C and HIV is receiving the utmost attention from VA, Congress and veterans organizations. I regularly care for these veterans in my clinic at the VA Medical Center in Washington, D.C. I know them personally. I will not let them down," said Deyton.
