Hepatitis C tested prevalence and comorbidities among veterans in the US Northwest.
OBJECTIVE
(1) Investigate the epidemiology of hepatitis C virus infection among patients seen in the Veterans Administration Northwest Network; (2) examine time trends in testing practices and results; and (3) estimate the prevalence of hepatitis C virus infection among active patients.


BACKGROUND
Hepatitis C virus infection causes chronic hepatitis and cirrhosis and is a leading cause of end-stage liver disease. Hepatitis C virus antibodies are estimated to be present in 1.8% of the US population, but reports of its prevalence among US veterans range from 1.7 to 35%.


METHODS
Retrospective review of computerized medical records of veterans tested for hepatitis C from October 1994 through December 2000 (n = 37,938) at 8 Northwest Veterans Administration Medical Centers.


RESULTS
Among tested veterans, 8230 (21.7%) had evidence of hepatitis C virus infection. The number of patients tested increased annually from 2335 to 18,191, while the proportion with first-time positive hepatitis C test results decreased from 35 to 10%. This drop in tested prevalence was associated with a shift away from testing individuals at highest risk--those with positive hepatitis B serostatus, repeatedly elevated alanine transaminase levels, and drug use disorder diagnoses. We estimate that 11.4% of the Northwest Network veteran users are hepatitis C virus seropositive, with a lower bound of 4.0% and upper bound of 19.5%.


CONCLUSIONS
Although estimates of hepatitis C virus infection rates among veteran users of the Veterans Administration system remain higher than those for the general population, changes in testing practice make generalizations from earlier studies hazardous.
Sloan
Kevin L
KL
Veterans Affairs Puget Sound Health Care System, Mental Health Service and the Addictions Treatment Center, Seattle, WA 98108, USA. Kevin.Sloan@med.va.gov
Straits-Tröster
Kristy A
KA
Dominitz
Jason A
JA
Kivlahan
Daniel R
DR
D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014728:Veterans / Q000706:statistics & numerical data*