1007. Prevalence of Hepatitis C Infection in Veterans: VA Cooperative Study #488
Jason A Dominitz, MD, MHS, VA Puget Sound Healthcare System and University of Washington School of Medicine, EJ Boyko, VA Puget Sound Healthcare System and University of Washington School of Medicine, TD Koepsell,
VA Puget Sound Healthcare System and University of Washington School of Medicine, PJ Heagerty,
VA Puget Sound Healthcare System and University of Washington School of Public Health, C Maynard,
VA Puget Sound Healthcare System and University of Washington School of Public Health, JL Sporleder,
VA Puget Sound Healthcare System
Objectives: Several studies have suggested that veterans have a higher prevalence of hepatitis C virus (HCV) infection than the general population. The objective of this study was to estimate the prevalence of anti-HCV antibody and risk factors for infection among users of VA medical centers.
Methods: Using a population-based, two-staged cluster sample, cross-sectional design, 1288 of 3863 randomly selected veterans who had used one of 20 randomly selected VA facilities completed a survey and were tested for HCV. Demographic and clinical data were available for most non-participants.
Results: The prevalence of anti-HCV antibody among serology participants was 4.0 per 100 (95% confidence interval (CI) 2.6-5.5). The estimated prevalence in the full population of VA users was 5.4 per 100 (95% CI 3.3-7.5) after adjustment for sociodemographic and clinical characteristics. Predictors of seropositivity included age, marital status, lower income, period of military service, prior diagnoses (e.g. drug and alcohol use), healthcare utilization, and lifestyle factors (e.g. tattoos, homelessness). Using logistic regression to adjust for injection drug use and non-participation, the odds of seropositivity were increased among veterans with prior testing for HCV and HIV, tattoos, and incarceration for 48 hours or more.
Conclusions: The prevalence of HCV in veterans exceeds the estimate from the general US population, likely reflecting more exposure to HCV risk factors among veterans that use VA facilities.
Impact: As these HCV infected patients age, the VA will be faced with dramatic increases in the number of veterans with complications of HCV, including liver failure and cancer.