Chronic hepatitis C virus (HCV) is the most common blood-borne pathogen in the United States. HCV disproportionately affects Veterans Affairs (VA) health-care users: 174,302 HCV-infected veterans were in VA care in 2013, making the VA the world's largest HCV care provider. This systematic review identified 546 articles related to HCV in the VA. After assessment by 2 independent reviewers, 28 articles describing prevalence and treatment of HCV in VA users ultimately met inclusion criteria. Most VA patients currently living with HCV infection were born between 1945 and 1965 and were infected with HCV between 1970 and 1990. To prevent HCV-related complications such as cirrhosis, hepatocellular carcinoma, and death, medical personnel must identify and treat HCV. However, antiviral therapy has historically been limited by medication side effects, contraindications, and patient acceptance. Although treatment initiation rates are higher in the VA than in the general United States, only 23% of VA HCV patients have received treatment and, of those, only a minority were cured. Recent development of more effective and tolerable antiviral agents represents a major pharmacological breakthrough. Eradication of HCV is theoretically possible for the majority of HCV patients for the first time, although new barriers, such as high drug costs, may limit future uptake.

中文翻译：

---

美国退伍军人事务部对慢性丙型肝炎病毒感染的流行和治疗。

慢性丙型肝炎病毒（HCV）是美国最常见的血源性病原体。HCV对退伍军人事务（VA）的医疗保健使用者的影响不成比例：2013年，有174,302 HCV感染的退伍军人在VA护理中，使VA成为世界上最大的HCV护理提供者。该系统评价确定了546篇与VA中的HCV相关的文章。经过2位独立审阅者的评估，描述VA用户中HCV患病率和治疗方法的28篇文章最终符合纳入标准。当前大多数感染HCV的VA患者出生于1945年至1965年之间，并于1970年至1990年之间感染了HCV。为预防与HCV相关的并发症，例如肝硬化，肝细胞癌和死亡，医务人员必须识别和治疗HCV。但是，抗病毒疗法历来受到药物副作用的限制，禁忌症，患者接受。尽管VA的治疗起始率高于美国，但仅VA HCV患者中有23％接受了治疗，其中只有少数治愈。更有效和可耐受的抗病毒药物的最新发展代表了一项重要的药理学突破。尽管大多数新的障碍（例如高昂的药物费用）可能会限制将来的吸收，但理论上首次可以使大多数HCV患者根除HCV。更有效和可耐受的抗病毒药物的最新发展代表了一项重要的药理学突破。尽管大多数新的障碍（例如高昂的药物费用）可能会限制将来的吸收，但理论上首次可以使大多数HCV患者根除HCV。更有效和可耐受的抗病毒药物的最新发展代表了一项重要的药理学突破。尽管大多数新的障碍（例如高昂的药物费用）可能会限制将来的吸收，但理论上首次可以使大多数HCV患者根除HCV。