Veterans and Hepatitis

Soldiers face all kinds of hazards during their service to our country and not all of them are combat-related. Through many a war and even during times of peace, those who serve in the military are exposed to a variety of diseases, the result being a large percentage of veterans who discover, often long after their service is complete, that they are sick.

Hepatitis C (HCV) is one of those diseases that affect large numbers of current and former members of the military, especially those who served during the Vietnam era. HCV is defined as a chronic viral blood-borne illness that usually remains latent in the body for anywhere from 10 to 30 years. The virus was first isolated in 1989 and screening became available 3 years later, so those who served prior to that time may be walking around with the disease without even knowing they have it.

Studies conducted by various health agencies show that about 1.8 percent of the general population is infected with Hepatitis C. In contrast, studies of veterans in VA facilities show that the rate of the disease among the veteran population is about 10 to 20 percent.

Why do vets exhibit such a high rate of HCV? The major reason is because Hepatitis is contracted through blood-to-blood contact. In the military, such contact is prevalent. The VA notes that the major causes of these high numbers of HCV victims are field bleeding, surgery, transfusions, and exposure to blood by military medics and surgeons.

It’s also noted that veterans who served in foreign combat are the most likely to contract the disease because the prevalence of HCV in some foreign countries is very high. Veterans from World War II, Korea, and Vietnam have shown the most susceptibility, with Vietnam vets having the highest number of incidences of Hepatitis C.

Risk Factors for Vietnam Vets

Of the 3.2 million soldiers who served in Vietnam, it is believed that at least 10 percent of those individuals have Hepatitis C. Many of these vets are just noticing the symptoms because of the long latency period. There are several reasons for the high incidence of the disease among Vietnam veterans.

Southeast Asia has a high rate of HCV among its native peoples
The Department of Defense reports that about 365,000 blood transfusions were given in Vietnam between 1967 and 1969. Blood was not screened for diseases.
Any of the 2.1 million soldiers and support personnel who handled the evacuation and treatment of the wounded were susceptible to the disease.
Many active duty personnel received tattoos while in Vietnam. They may have been infected by re-used, dirty needles.
Illegal drug use was common among those who served in Vietnam. The Centers for Disease Control notes that some 3 percent of those who fought used “hard” drugs and that sharing drug paraphernalia was common. Today, this practice still accounts for the most cases of HVC.

Diagnosis

Many people with Hepatitis C have no symptoms at all, so diagnosis can be difficult. Those with early symptoms, however, may mistake them for the flu as they include things like mild fever, muscle aches, headache, fatigue, and diarrhea. More obvious symptoms come in the later stages and include dark urine, clay-colored stools, abdominal pain, and jaundice.

To definitively diagnosis the disease, doctors use a test that checks for the presence of a particular antibody, which is present in about 50 percent of all those who have HVC. Because the disease affects the liver, a liver biopsy may need to be performed to assess the damage to that organ.

Treatment

Acute Hepatitis C is treated with bed rest, lots of fluids, healthy diet, and avoidance of alcoholic beverages. Symptoms generally subside in a few weeks.

Chronic HVC, the form from which many veterans suffer, may be treated with a synthetic form of the protein interferon. This is intended to improve liver function. However, records show that it is only effective to 10 to 40 percent of all cases. Unfortunately, about 50 percent of all those with chronic HVC go on to develop cirrhosis of the liver or liver cancer, two very deadly diseases.

The VA and Hepatitis

In order for a Hepatitis C victim to receive treatment from the Department of Veterans Affairs healthcare system, the individual must be able to show a service-related connection to their disease. Without this, veterans will be unable to receive the care they need. In addition, the long latency period of the disease and the lack of a reliable test, both presently and in the past, make service connection particularly difficult to prove.

The following list represents recognized service-connected transmission methods for Hepatitis C. According to the VA, if a veteran applies for benefits and does not have "other" risk factors besides these, or can prove service was a "greater risk" for infection with Hepatitis C, he/she will be eligible for service connection.