Senate Veterans Affairs Meeting
Hepatitis C Transmission
Oct 22, 2015
VA Hep C Treatment Guidelines
UPDATE: Feb 26,
Prioritization Status Update
UPDATE: March 2016
VA Hep C Treatment Guidelines
VA to treat all vets in system
Vietnam vets blame 'jet guns' for
their hepatitis C
By Lily Leung
Feb. 14, 2016
By Judith Graham
VA Extends New Hepatitis C Drugs to
All Veterans in Its Health System
CBS News Investigates
Congress outraged over hepatitis C
treatment VA can't afford
Dr. Raymond Schinazi played a
leading role developing a drug that
cures hepatitis C while working
seven-eighths of his time for the VA
Hepatitis C drug costing VA, DoD millions
By Patricia Kime, Staff writer
We're looking at a company
who is milking a cash cow for everything
it's worth," Sanders said.
VA to outsource care for 180,000 vets
with hepatitis C
Dennis Wagner, The Arizona Republic
12:27 a.m. EDT June 21, 2015
VA to outsource care for 180,000 vets with
Dennis Wagner, The Republic | azcentral.com 11:51 a.m. MST June 19, 2015
Dr. David Ross, the VA's
director public-health pathogens
programs, resigned from the working
group. "I cannot in good conscience
continue to work on a plan for
rationing care to veterans," he
VA Region Stops Referring Patients To
Outside Hospitals Thanks To Budget Shortfall
Michael Volpe Contributor
...According to a memo — the entire region has been forced to
stop all “non-VA care” referrals due to
a budget shortfall.
OIG INVESTIGATES VA CHOICE PROGRAM
Sen. Mark Kirk admitted the VA
Choice Program is a failed joke in a
letter to Secretary Bob McDonald
despite attempts to fix it.
Denied Hep C VA dental care?
Dried Hepatitis C Blood Exposure
blood transmits virus
and more likely to cause accidental
Lack of Standards
2014 AASLD Study
Hepatitis C not an STD
Test the Rest Campaign
Meeting Sen. Sullivan's Office- Jetgun
Documentation & Surveillance Alerts
Military Hepatitis History
Understanding The Liver
VA Flow Sheet for Cirrhosis
VA Defines Risk Factors
Hep C & Pro-Prebiotic
Need to know-Grassroots Research
One Vets' Journey Though Treatment
What Would Veterans Do?
Blog for VA Claims
Help with VA Claims
VBA Fast Letter Boost Claims
Legal- Fed Regs state:
Judge decision may be relied upon
Cotant v. Principi,
17 Vet.App. 116, 134 (2003),
Service Connected Claims
Conclusion of Law
Conclusion of Law
Hep C Decisions
Search Board of Appeals Website
BVA Jetgun Decisions
BVA Hepatitis C Decisions
After the jetgun win
What to do next
body piercing get more than lip service
THE NEW YORK TIMES
At a tattoo and piercing establishment on St. Marks Place in
Manhattan recently, Young-Cho, an experienced tattoo artist, applied
a small winged horse to Mara Fallon's shoulder.
He dipped his buzzing instrument into a small plastic cup of blue
ink and then appeared to draw with the electric needle on Fallon's
"It feels like when you pull hairs out when you rip off a Band-Aid,"
In another cubicle, Tino, a piercer, disinfected the skin on a young
woman's abdomen and marked two dots on either side of her navel. He
held her flesh with forceps and pierced the marks with a hollow
needle, then threaded a surgical steel rod through the four holes
and attached two small steel spheres to each end, making the jewelry
into a tiny barbell.
Tattoos and body piercings have become so common, they hardly
attract notice. One recent study of 7,960 college students in Texas
found that one in five had at least one tattoo or piercing of a body
part other than an earlobe.
But health officials say they are increasingly worried about the
risks posed by such body modification practices, including physical
disfigurement and bacterial and viral infections, and not only from
needles that draw blood in potentially unsanitary conditions.
The primary concern is infection with blood-borne pathogens such as
HIV and hepatitis C and B. But doctors say that tongue and genital
piercings can also provide channels for bacteria and viruses to
enter the bloodstream after the piercing procedure.
Bacteria that live on the skin, including some penicillin-resistant
forms of staphylococcus, are easily spread by unsterilized
instruments or ungloved hands. And bacterial infections, or the
body's reaction to the insertion of a foreign object, can cause
deformities at piercing sites.
Last month, Sen. Charles Schumer, D-N.Y., expressed concern about a
growing number of hepatitis C cases, linking the increase in part to
body piercings and tattoos. The potentially fatal virus can live in
the body for decades without symptoms.
Studies have not conclusively demonstrated a connection between body
modification and hepatitis C. The Texas study, sponsored by the
federal Centers for Disease Control and Prevention, found that
college students with piercings, tattoos or both were no more likely
than other students to have been exposed to the hepatitis C virus.
But an earlier study reported that of 626 patients at an orthopedic
clinic, those with tattoos were seven to eight times more likely to
have subclinical hepatitis C infections.
"Regardless of whether or not we can demonstrate that bacteria or
viruses are spread in this manner, anything that pierces the skin
and has blood on it can potentially spread an infection," said Dr.
Miriam Alter, associate director for science at the Centers for
Disease Control's division of viral hepatitis and the agency's lead
scientist on the Texas study. "The moment you pierce the skin
barrier, there is risk for transmission of a disease."
Licensing requirements for tattoo and piercing establishments, the
growth of professional organizations for practitioners and the
growing sophistication of Internet-educated consumers have increased
safety. Most people seeking tattoos know they should see the artist
remove a new needle and tube setup from sealed plastic and that
fresh ink from disposable containers should be used.
But Dr. David Graham said it is impossible to police everyone.
"There will always be someone driven by profit who will avoid
regulatory guidelines and licensing fees," he said. And even
establishments that use fresh needles and surgical gloves, spray
disinfectants and heat-sterilizing autoclaves are of concern,
It is estimated that one piercing in 10 becomes infected.
Staphylococcus bacteria, which can live on the skin and in the nose,
are a frequent cause, said Dr. Scott Hammer, professor of medicine
at Columbia College of Physicians and Surgeons.
"If you disinfect the surface of the skin but use a forceps that has
not been sterilized, you are risking spreading infection," Hammer
said. "You don't need a puncture; you only need an abrasion for the
organism to cause an infection."
Unlike most tattoos, which heal in one to two weeks, piercings can
pose problems in the long haul. Nipple piercings that go too deep
have damaged tissue and led to problems in breast-feeding after the
jewelry was removed.
Stud earrings can become embedded in nipples, navels or elsewhere
when the body tries to "heal over" the piercing site. Clothing can
catch on navel jewelry, causing infections. Keloids, the overgrowth
of scar tissue, can also cause disfigurement, including tumorlike
Some styles of mouth and genital piercing carry other dangers. Dr.
Jay Gohel, a dentist at the Smile Institute in Manhattan, said
tongue rings could cause trauma and breakage of the upper teeth,
including the lingual cuspids and molars.
"Every time you move the tongue, it's banging on the teeth," Gohel
said. "It's like tapping on glass over and over again. It finally
Gohel and other experts have also seen infections from tongue
piercings. One study reported on the case of a 25-year-old man with
a potentially fatal disease of the heart's inner lining that was
traced to his tongue piercing.
Many people use antibiotics as a preventive measure before dental
surgery because of congenital heart disease, heart defects or
repaired heart valves. Dr. Nieca Goldberg, chief of women's cardiac
care at Lenox Hill Hospital in New York, said that people in
high-risk categories might not realize that they should also take
protective medication before piercings.
"You may think of a piercing as cosmetic, but if you have . . .
conditions that require antibiotics before dentistry, you should be
treating a piercing the same way," Goldberg said.
Contact the Omaha World-Herald newsroom