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Michael E. DeBakey VA Medical Center - Houston, Texas

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Houston VA Focuses on Hepatitis Awareness

July 16, 2002

Houston VA Focuses on Hepatitis Awareness
Released: 2002/07/16

Dr. Shahriar Tavakoli-Tabasi
Photo by HVAMC Education Service Line
Dr. Shahriar Tavakoli-Tabasi, HVAMC Hepatitis C Coordinator, was instrumental in establishing a computerized hepatitis C clinical reminder program at the Houston VA Medical Center that automatically detects patients who have not been tested for hepatitis C and prompts their Primecare provider to ask for risk factors for hepatitis C.

HOUSTON, TX - Aware that there are 3.5 million Americans chronically infected with the hepatitis C virus, Department of Veterans Affairs (VA) medical facilities are focusing on preventing and treating hepatitis C infections. The goal is to make sure veterans know about risk factors for hepatitis C infection and how to get screened and tested at VA facilities.

The Houston VA Medical Center (HVAMC) has treated more than 330 veterans for hepatitis C in the last four years. Last year, there was more than a 50 percent increase in the number of treated patients. Over 500 veterans have received vaccination against hepatitis A and/or B in the HVAMC Hepatitis C Clinic.

Each patient who is seen in Hepatitis C Clinic is fully evaluated for the need for vaccination, and vaccinations are administered accordingly. The HVAMC now has one of the highest number of treated patients for hepatitis C in VA VISN #16 and one of the highest numbers nation-wide.

"In a short time, VA has established the largest screening and testing program for hepatitis C infection in the world," said Secretary of Veterans Affairs Anthony J. Principi. "Hepatitis C testing, treatment, and research are among VA's highest health priorities."

Hepatitis C is a virus that infects the liver, causing tissue damage and, in some cases, permanent liver problems, including cirrhosis (scarring) and liver failure. It is a leading reason for liver transplantation. Hepatitis C has been recognized as a cause of liver disease for about a decade, and testing has been available only since 1992.

"The Houston VA Medical Center has taken a vigorous, aggressive approach to this relatively new disease," said Dr. Thomas Horvath, HVAMC Chief of Staff. "In September 2000, we established a Hepatitis C Clinic staffed by an infectious disease specialist and a LVN who devote 24 hours each week to the care of hepatitis C patients. This clinic is in addition to physicians in our GI department who are also treating patients with hepatitis C."

Every veteran who is referred to the Hepatitis C Clinic gets a computerized presentation, a handout prepared by the VA Centers of Excellence for hepatitis C, and a 40-minute visit with the hepatitis C physician. This visit focuses on patient education and the disease.

The HVAMC Hepatitis C Clinic is taking steps towards meeting the demands of the public health principles underlying the VA National Hepatitis C Program. In late 2001, the HVAMC Primecare Clinic, in conjunction with the Hepatitis C Clinic, established a computerized clinical reminder program that automatically does the following:

  1. Automatically detects patients who have not been tested for hepatitis C and prompts their Primecare provider to ask for risk factors for hepatitis C. If a risk factor is identified, the program prompts for the healthcare provider to order a screening test.
  2. If a positive screening test is detected, the software prompts the health care provider to order a confirmatory test and/or send an automatic consult to Hepatitis C Clinic.
  3. If a positive confirmatory test is detected, the health care provider is prompted to send a consult to the Hepatitis C Clinic.
  4. High risk patients are automatically retested every two years. VA has screened more than 1.7 million veterans for risk factors associated with hepatitis C infection and each year cares for over 70,000 veterans with the disease.

VA's coordinated services provide veterans with state-of-the-art care, ranging from counseling for risk factor identification and disease prevention, to providing medication and health care, including liver transplantation. Additionally, VA provides support services such as substance abuse and mental health care.

"We are managing hepatitis C infection through a comprehensive approach to prevent disease transmission and long-term complications," added Horvath. "This is a model for how other large systems can manage this serious disease."

If you are concerned about hepatitis C, please talk with your Primecare team during your next appointment. For more about hepatitis C, visit on the Internet.

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Point of Contact: VHAHOU Public Affairs

04/21/04 08:25