Military Personnel At Lower Risk of

Hepatitis C Infection Than Civilians,

Study Says


Apr 11, 2001

Dave Eberhart

Stars and Stripes Veterans Affairs Editor


Military personnel are at three to five times lower risk

of becoming infected with the hepatitis C virus (HCV)

than the civilian population. The primary reason:

Members of the uniformed services are less likely to

inject drugs--the most prevalent mechanism by which

the disease is spread.


Those findings are contained in an epidemiological

study, a joint effort of the Defense Department, the

federal Centers for Disease Control and Prevention

(CDC) and the VA, that was released April 10.


HCV, which is carried by nearly 4 million Americans,

is a leading cause of chronic liver disease in the United

States and now the most common reason for liver

transplantation. Hepatitis C is a slowly progressive

disease that frequently is without symptoms for 10 to

30 years.


The results of the study, one of the largest

epidemiological studies of hepatitis C virus infection on

record, was published last week in the American

Journal of Epidemiology.


More Veterans Infected


The researchers found that, among 10,000 active duty

personnel, only 0.5 percent had HCV, and men and

women had the same rates of infection. Among adults

in the general population, 3.7 percent of the males and

1.6 percent of the females (2.6 percent overall) were

found to be infected, according to the CDC.


Veterans, however, are faring much worse than either

active duty personnel or civilians, according to earlier

VA data.


In January, The Stars And Stripes reported the VA as

estimating that almost 7 percent of veterans are

infected with HCV--a rate three times that of the

civilian population--and that "some veterans returned

from Vietnam unaware that they had become infected."


The hepatitis C virus was not identified until 1989.


"According to Gary Roselle, M.D., of the Cincinnati

VA Medical Center, 54,682 Vietnam-era veterans

tested positive for hepatitis C between 1998-99," The

Stars and Stripes reported. "Their average age was

49.4 years."


Kirt Love, a Gulf War veteran who heads the Desert Storm

Battle Registry, told Stripes April 11 that he takes a

dim view of the latest study. "There are no third parties

or [civilians] to help verify that the study was genuinely

objective," he said.


Love said the military's HIV blood bank, which includes

skin tissue samples and biopsies turned over to the Armed

Forces Institute of Pathology, might be a better resource

for such studies.


"We have been trying for a long time to get permission

to use the resources of the vault to collect and interpret

truly meaningful data," he said.


21,000 Examined


The latest study examined 21,000 military personnel

who were serving in 1997. Blood samples from the

DoD Serum Repository were used to test for HCV

antibodies in a segment directed by the Naval Medical

Research Center in Silver Spring, Md.


In addition to active duty personnel and recruits, the

study subjects included 2,000 reservists, 2,000 troops

about to retire, 1,000 health care personnel, 1,000

troops who served prior to 1974 (the Vietnam War

era) and members of 3,000 other demographic groups.


Reservists were found to have the same level of

hepatitis HCV infection as troops on active duty, and

health care personnel and Vietnam-era veterans were

found not to be at a higher risk of infection.


HCV infection was found to be concentrated in older

military personnel.


"Among troops less than 35

years of age, only 0.1 percent, or

one out of 1,000 troops, had

been infected," said Dr. John

Mazzuchi, deputy assistant

secretary of defense for health

affairs. "Likewise, among 2,000

military recruits, two, or 0.1

percent, had previously been

infected with the hepatitis C



Screening Now Offered


As a result of the study, HCV screening is being

offered to personnel older than age 34 and those

separating or retiring from the military, Mazzuchi said.


"Because this age group includes 80 percent to 90

percent of troops with hepatitis C virus infection, we

have implemented this program to screen the military

population at highest risk," he said.


"In addition, we have implemented an extensive

program to identify patients who may have been

infected with the hepatitis C virus through a blood

transfusion before scientific research had developed an

accurate test for this disease."


Illicit drug use, officials say, is rare in the U.S. military

because of the mandatory drug-testing of new recruits

and random tests of personnel throughout their service,

according to Mazzuchi.



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