Veterans have a higher risk of developing a hepatitis C infection, especially if they served during the Vietnam era. This may be because military veterans may have more of the traditional risk factors for the condition, such as using injected drugs, along with having had transfusions or tattoos.

In contrast with veterans, people on active duty in the military have a lower risk. This may be due to less frequent injection drug use because the military carries out mandatory testing for harmful drugs in the service.

The hepatitis C virus (HCV) is a bloodborne virus. This means that people, who have contact with blood from a person with the infection, can contract hepatitis C infection. Hepatitis C can damage the liver and can cause liver cirrhosis and hepatocellular carcinomas in some people.

Read on to learn more about the link between hepatitis C and veterans, including transmission, long-term effects, and the risk factors of contracting hepatitis C.

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According to the Department of Veterans Affairs (VA), about 3 million people in the United States have chronic hepatitis C. While the rate of the infection is 1.8% in the general U.S. population, it increases to 5.4% in veterans, who enrolled for care from the VA.

The VA has cured over 100,000 veterans with chronic hepatitis C since 2014, using drugs called direct acting antivirals (DAAs). Studies show that a combination of second-generation DAA regimes, such as sofosbuvir and simeprevir, produces fewer adverse effects and higher cure rates.

Research from 2018 reports that veterans most likely affected by hepatitis C are people who:

  • served during the Vietnam war era
  • have alcohol or substance use disorders
  • have psychiatric conditions
  • experience homelessness

Learn more about hepatitis C infection here.

An older 2005 study suggests that retired veterans have a higher risk of hepatitis C. This might stem from veterans having a higher number of the traditional risk factors associated with hepatitis C infections, including:

  • blood transfusions
  • a history of injected drug use
  • having tattoos

The study did not find that their higher risk was due to military-related exposures.

Additionally, research shows that the highest prevalence of hepatitis C infection was in service members who served in Vietnam between 1964–1975. This seems to be due to battlefield exposures with HCV-infected blood, sharing of HCV-infected personal items, such as razors or toothbrushes, and the use of unscreened blood products.

Research from 2015 indicates that, unlike retired veterans, the active-duty military has a lower risk of developing hepatitis C infection. The percentage risk ranges from 0.04–0.48%.

Moreover, researchers from an older 2001 study attribute the lower prevalence among the active-duty military to mandatory testing for illicit drugs. This testing happens before people enter the military, as well as throughout their service.

A severe enough presentation of hepatitis C in a veteran may entitle them to receive disability benefits from the VA. The government assigns ratings or percentages that indicate the severity of the veteran’s condition. The specific ratings can determine the number of benefits a veteran receives.

Transmission of hepatitis C usually occurs when someone has contact with the blood of a person with the infection, notes the Centers for Disease Control and Prevention (CDC). Sharing drug injection equipment, such as needles or syringes, is the most common route of transmission.

Another route of transmission is through birth from a pregnant person with the hepatitis C virus. The overall risk of a person with HCV passing the hepatitis C virus to their infant during birth stands at 4–8% per pregnancy.

Less frequently, the transmission of the hepatitis C virus can occur through:

  • Having sex with someone with HCV: This is uncommon, but it happens more frequently when men have sex with men with HIV.
  • Exposure during healthcare: While this is uncommon, it can happen when healthcare workers do not follow the proper procedures that prevent the spread of bloodborne infections.
  • Sharing personal items: The infection can transmit when people share items — such as nail clippers, toothbrushes, and razors — that contain blood with the infection.
  • Getting unregulated body piercings and tattoos: This can occur when getting tattoos with nonsterile instruments or in unlicensed facilities.
  • Organ transplants and blood transfusions: This risk has become extremely low in the U.S. since the widespread screening of blood supplies started in 1992.

The CDC states that hepatitis C does not transmit through the following actions:

  • consuming food or drink
  • sharing eating utensils
  • holding hands
  • hugging or kissing
  • breastfeeding or chestfeeding
  • sneezing or coughing

Testing is important to help prevent transmission.

The VA recommends testing for all people, including veterans, between the ages of 18–79. The test is usually free for all veterans enrolled in the VA healthcare program, but some places may require copays.

A blood test checks for the presence of the hepatitis C virus. If a person’s test shows that they currently have hepatitis C, they are capable of transmitting it to others. When someone becomes aware that they have the infection, they can take precautions to avoid its spread.

As of 2019, less than 25,000 veterans in VA care still require testing.

Who should get tested?

Experts recommend that people regularly get a hepatitis C test if they currently inject drugs. They also advise regular testing for those who receive maintenance hemodialysis, a treatment that filters waste from the blood when kidney disease is present.

People with additional risk factors may require more regular screening.

Testing also identifies those who need treatment. Medications, called DAAs, are available for hepatitis C that can cure most individuals in 8–12 weeks. Curing hepatitis C can prevent it from progressing to advanced liver disease, which can cut the death rate by up to 50%.

Learn more about how doctors treat hepatitis C here.

Eligibility for VA healthcare

Veterans who qualify for VA healthcare benefits may receive coverage to help pay for care, treatment, and certain services.

Veterans may check their eligibility for benefits and information about copays through the VA Benefits website or by calling 1-877-222-8387 for more details.

Some risk factors for hepatitis C infection include:

  • using injection drugs in the present or the past
  • having an HIV infection
  • having certain conditions, including those involving maintenance hemodialysis and those with persistently abnormal levels of the enzyme alanine aminotransferase
  • having received transfusions or an organ transplant before July of 1992
  • having received clotting factor concentrates made before 1987
  • being born to a pregnant person with hepatitis C
  • having an occupation in healthcare or public safety that involves the risk of a needle-stick injury or other exposure to the blood of someone with hepatitis C

If a person does not receive treatment, hepatitis C may become a lifelong infection.

A chronic hepatitis C infection may cause:

  • liver damage
  • cirrhosis, or scarring, of the liver
  • liver cancer
  • death

The Department of Veteran Affairs reports that there is a higher prevalence of hepatitis C infections in veterans than in the general population, especially if they served in the Vietnam war era. Eligible veterans may be able to get financial support for testing and treatment of hepatitis C.

Transmission occurs from exposure to the blood or body fluids of a person with the infection. The most common means of transmission is through injection drug use.

If someone with hepatitis C does not receive treatment, the infection can have serious consequences, including liver cancer. This is why testing is important, as medications are available that can cure most people in 8–12 weeks.