The Department of Veterans Affairs (VA) health system, the largest single provider of hepatitis C virus (HCV) care in the United States, appears to be on track to soon cure hep C in more than 100,000 former U.S. service members.
Compared with the overall population, veterans have a higher prevalence of HCV—as high as 5%, or about triple the general population rate. The rate is especially high among baby boomers (those born between 1945 and 1965), which includes Vietnam War veterans.
Despite the availability of effective treatment, many people with hep C in the general population have not been cured because of barriers such as a lack of awareness, inadequate screening, a shortage of providers and the high cost of the drugs. But the VA—which provides consistent free or affordable care for veterans and maintains extensive electronic health records—offers the opportunity to overcome these barriers.
The first direct-acting antiviral (DAA) drug, Sovaldi (sofosbuvir), was approved in December 2013. Before 2014, only 12,000 of the approximately 180,000 veterans with chronic HCV under the care of the VA had been treated and cured using interferon-based therapy, which was often poorly tolerated and much less effective than DAAs.
As of the beginning of March, nearly 116,000 veterans currently under VA care had started DAAs. Of these, 96,654 (83%) have already completed treatment and been cured.
The remainder of those now on treatment will most likely finish by the summer, and the vast majority of them will be cured. By October, the VA expects to have treated more than 125,000 people.