September 5, 2003
|HVAMC Hepatitis C Clinic Manager Shahriar Tavakoli-Tabasi, M.D. examines veteran Margarito C. Vasquez. "While aggressive treatment of Hepatitis C is extremely important, education is equally as important. At the Houston VA Medical Center, using education, we are trying to take away the phobia people have about hepatitis C," said Tavakoli-Tabasi.
photo by Bobbi D. Gruner, HVAMC Public Affairs Officer
HOUSTON, TX - Did you know you could have hepatitis C and not even know it? It's true. Hepatitis C is a multifaceted disease of the liver caused by an infection with the hepatitis C virus. It is the most common blood-borne infection in the U.S., affecting approximately 4 million people. Most people infected with this disease have few, if any symptoms, and feel for the most part, very normal. For some persons, the most common symptom is extreme fatigue. On top of that, hepatitis C is sometimes very difficult to diagnose. The only way to tell if you have been infected with hepatitis C is to have a blood test.
These are just two key reasons why every veteran who is seen in the Houston VA Medical Center (HVAMC) Prime Care Clinic is screened for hepatitis C.
"About 85 percent of vets who come in for treatment at the Houston VA Medical Center are screened upon their initial visit to the medical center by their primary care provider, by the second or third visit almost 100 percent of the patients have been screened for this disease," said Shahriar Tavakoli-Tabasi, M.D., manager of the HVAMC Hepatitis C Clinic.
"In a short time, VA has established the largest screening and testing program for hepatitis C infection in the world," said Thomas C. Horvath, M.D., HVAMC chief of staff. "Hepatitis C testing, treatment, and research are among VA's highest health priorities."
The age groups most affected by hepatitis C are veterans of the Korean and Vietnam eras before the disease was well known. However, you may have received contaminated blood before tests to identify blood donors with hepatitis C were available or when they were less precise than they are now.
Hepatitis C is not spread by kissing or hugging, sneezing, sharing eating utensils or drinking glasses, sitting next to someone, or even holding someone's hand. Hepatitis C is spread primarily by coming in contact with an infected person's blood.
Hepatitis C is a serious disease because it can progress to cirrhosis and severe liver damage. In some people, the progression is very slow while in others, it can happen very quickly. Most people with hepatitis C carry the virus their entire life. Most of these people do have some liver damage, but many do not feel sick from the disease.
Some people with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure in 20 to 30 years, while others only have mild liver damage in that time. Medical studies examining people with hepatitis C have strongly linked drinking alcohol, even only a few drinks a day, to a significant increase in the rate and chance of liver damage.
Interferon and ribavirin are two drugs used to treat chronic hepatitis C. Combination therapy, using pegylated interferon and ribavirin, is currently the treatment of choice.
While using these and other medications, doctors at the HVAMC want to provide complete care for veterans with hepatitis C, not just dispense medication. This means also treating veterans for possible depression, Post Traumatic Stress Disorder, and alcohol or drug abuse.
"Education is the key in managing hepatitis C," said Tavakoli-Tabasi. "Veterans must understand that alcohol, even in small amounts, has a direct effect on the treatment and management of their disease. Alcohol is a very strong factor leading to liver failure." Studies have shown alcohol increases the rate of damage caused to the liver by hepatitis C, and it interferes with the medications used to treat the disease.
A major goal of the HVAMC is to increase awareness and education about hepatitis C, not only in the veteran population, but also among family members of veterans, HVAMC health care providers, and the community at large.
Every veteran who is referred to the HVAMC Hepatitis C Clinic receives 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.
"While aggressive treatment of hepatitis C is extremely important, education is equally as important. There are three key points in educating veterans and the public. First, treatment is available, but it's not a cure. You can live many, many years without problems if you take care of yourself. Second, hepatitis C is contagious mainly through blood and sharp objects such as razors. It's mainly transmitted through blood," said Tavakoli-Tabasi. "And finally, hepatitis C patients must change their lifestyles to avoid alcohol altogether. Hepatitis C plus alcohol greatly increases the changes of liver failure. Abstaining from alcohol can prolong a veteran's life. At the Houston VA Medical Center, using education, we are trying to take away the phobia people have about hepatitis C."
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article by Veda McDonald, Emerging VA Leadership Program Mentee
Point of Contact: VHAHOU Public Affairs04/21/04 08:25