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May 2014 VA Hep C Treatment Guidelines
UPDATE: Feb 26, 2016-
Funding and Prioritization Status Update

UPDATE: March 2016
VA Hep C Treatment Guidelines
VA to treat all vets in system
 

By Judith Graham
VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

 
Orange Count Registry
Vietnam vets blame 'jet guns' for their hepatitis C
By Lily Leung Feb. 14, 2016 
 
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
 
ibtimes.com| By amynordrum
 


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 hepatitis C
, 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 wrote.
 


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.
 

DisabledVeterans.org
OIG INVESTIGATES VA CHOICE PROGRAM PROBLEMS
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?
Please click here

 
Dried Hepatitis C Blood Exposure 11/23/2013 Weeks later inconspicuous blood transmits virus and more likely to cause accidental exposures to Hep C
 

Lack of Standards for
Mass Vaccinations
1970 Jetgun Nursing Instructions
 

2014 AASLD Study Hepatitis C not an STD

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Blog for VA Claims
 


Help with VA Claims
 


 
Info: Plan Backfires-
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
# 1 Conclusion of Law 
# 2 Conclusion of Law 
 
More Claims
Jetgun Decisions
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VA physicians
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Great Advice!  
After the jetgun win
What to do next

 

 


Detection of hepatitis C virus-RNA by polymerase chain reaction in dental surgeries.

Piazza M; Borgia G; Picciotto L; Nappa S; Cicciarello S; Orlando R Institute of Infectious Diseases, University of Naples Federico II, Italy. J Med Virol 45: 40-2 (1995)

Abstract

The mean prevalence of anti-hepatitis C virus (HCV) in Italy is 0.87%. It reaches 2% in Campania, Southern Italy. Approximately 50% of community acquired non-A, non-B (NANB) hepatitis cannot be associated with known parenteral exposure. A recent Italian study has shown that the only demonstrable risk factor in 9% of acute C/NANB hepatitis is dental treatment. There are no data on direct contamination by HCV of dental surgeries. Possible environmental contamination by HCV-RNA was investigated in dental surgeries after treatment of anti-HCV and HCV-RNA positive patients. Thirty-five anti-HCV and HCV-RNA positive patients with chronic hepatitis underwent dental treatment and were enrolled in this study. Eight had chronic persistent hepatitis (CPH), 23 chronic active hepatitis (CAH), and 4 cirrhosis. A total of 328 samples collected from instruments and surfaces were tested after dental treatment of 35 anti-HCV positive patients. The presence of HCV-RNA was determined by polymerase chain reaction (PCR) to evaluate contamination of instruments and surfaces in dental surgeries. Twenty (6.1%) out of 328 collected samples were positive for HCV-RNA. The positive samples were from work benches (two), air turbine handpieces (one), holders (four), suction units (one), forceps (four), dental mirrors (two), and burs (six). Our data indicate that there is extensive contamination by HCV of dental surgeries after treatment of anti-HCV patients and that if sterilization and disinfection are inadequate there is the possible risk of transmission to susceptible individuals


Failure of gloves and other protective devices to prevent transmission of hepatitis B virus to oral surgeons.

JAMA 1988 May 6;259(17):2558-60 Reingold AL, Kane MA, Hightower AW Department of Biomedical and Environmental Health Sciences, School of Public Health, University of California, Berkeley.   

     A survey of 434 oral surgeons was conducted to examine risk factors for hepatitis B virus (HBV) infection. Overall, 112 (26%) of the participants demonstrated serologic evidence of past or current infection with HBV. Seropositivity was significantly associated with age, number of years in practice, and year of graduation from dental school but not with other variables examined, such as the number of patients seen annually or the number of patients seen who were at high risk of HBV infection. The strong correlation between years in practice and seropositivity was unaffected by reported use of gloves, face masks, or eye shields. The use of gloves and other protective devices does not appear to offer substantial protection against HBV exposure in oral surgeons, and all oral surgeons should receive HBV vaccine. PMID: 3357229, UI: 88188297   


OSHA Preambles -     Bloodborne Pathogens (29 CFR 1910.1030)Revision Date: Jul 30 1999

Most healthcare workers who have transmitted to patients have several  factors in common (Exs. 6-476; 6-471): 

(1) The dentists and surgeons were chronic HBV carriers, had high titers  of virus in their blood (HBeAg positive), and were unaware that they were infected. 

(2) Transmission occurred most frequently during the most traumatic procedures. 

(3) The dental personnel who transmitted did not routinely wear gloves. However, some infected HCWs continued to transmit HBV to patients in spite of the use of gloves and additional precautions. 

(4) The dentists and surgeons often had a personal medical problem (such as exudative dermatitis on the hands), or used techniques that made transmission more likely. Several of the gynecologists used their index fingers to feel for the tip of the suture needle when they were performing deep abdominal surgery. http://www.osha-slc.gov/Preamble/Blood_data/BLOOD4.html   


Veterans Administration cooperative study on hepatitis and dentistry. 

Am Dent Assoc 1986 Sep;113(3):390-6 Schiff ER, de Medina MD, Kline SN, Johnson GR, Chan YK, Shorey J, Calhoun N, Irish EF 

     Personnel in the VA dental facilities were screened for the detection of viral hepatitis and identification of factors implicating infectivity. A total of 963 personnel from 126 dental facilities throughout the United States voluntarily participated in the study. The rate of seroconversion for any hepatitis B markers was approximately 1% per year. Serial positive tests for antibody to hepatitis B core antigen or antibody to hepatitis B surface antigen (or both) were present in 16.2% of dentists and 13.0% of dental auxiliary personnel. Oral and maxillofacial surgeons composed the highest prevalence occupation (24.0%), and clinical personnel composed the lowest prevalence occupation (8.9%). There was a significant association between years in dental environment and serological positivity for viral B infection. The dentists and dental auxiliary personnel had significant linear trends of increasing serological positivity with years in the dental environment. Although a majority of personnel reported wearing gloves while treating high-risk patients or performing invasive procedures, inadequate prophylactic measures were exercised for most patients undergoing a variety of less invasive procedures. The results of the study show the need for an active immunization program against type B viral infection for dental and dental auxiliary personnel, preferably before the initial exposure to the professional environment. PMID: 3531282, UI: 87009463        


PHILADELPHIA INQUIRER AIDS VIRUS SURVIVES DENTAL-TOOL WASH HEAT STERILIZATION IS URGED. A STUDY FOUND WASHINGTHE TOOLS WITH DISINFECTANT DIDN'T DO THE JOB.
Published on 11/21/1992,

TEXT: The viruses that cause AIDS and hepatitis B can survive within dental tools that are washed with disinfectant but not heat-sterilized, posing a potential risk of disease transmission, according to a new study.

The recent case of a Florida dentist who transmitted the virus to five patients ignited widespread fear about catching AIDS from dental procedures. But the infected patients in Florida got the virus from the dentist, not from contaminated equipment, according to investigations