More than half, or roughly 700, of the 1,341 VA patients have been tested for hepatitis C, hepatitis B, and HIV, with two testing positive for hepatitis C since the historic health notification, said Dr. Ramu Komanduri, chief of staff of the VA Southern Nevada Healthcare System.

He said the two are in addition to one veteran who is among six patients who contracted hepatitis C linked to questionable practices involving reuse of vials and syringes at the Endoscopy Center of Southern Nevada on July 25 and Sept. 21.

The two new cases, however, had not been at the center on those dates, Komanduri said.

"So far, we've only had two new cases that have been identified. It doesn't mean they've been linked to this outbreak," he said. "They're positive tests but there's no guarantee. They could have had it for 20 or 30 years. You never know until you get tested."

All 1,341 veterans who went to the center last year were sent certified letters by the VA urging them to get tested. The letters were in addition to the 40,000 involved in the mass notification that also includes them and 1,800 active duty airmen and dependents from Nellis and Creech Air Force bases and Air Force retirees.

Two special VA clinics, one in the Las Vegas Valley's northwest side and one in the east, have been set up to conduct free blood tests for veterans to check for exposure to hepatitis and HIV.

The closed endoscopy center run by Dr. Dipak Desai and associates is located at 700 Shadow Lane in Las Vegas.

Veterans have a hepatitis infection rate double that of the general population -- 4 percent versus 2 percent -- which is attributed to tattoos, drug use, past military vaccination procedures and other factors.

While the mass notification was sent to patients who had visited the center since March 2004, the VA Southern Nevada Healthcare System had only used the center for fee-based referrals since January 2007. That was after a four-year VA contract with Desai that began in 2002 for doctors in his group had expired.

The competitive-bid contract for about $500,000 each year was issued by the VA contracting headquarters in Long Beach, Calif. It called for Desai and others, including Dr. Clifford Carrol and Dr. Ranadev Mukherjee, to conduct procedures on veterans at the VA's Southeast Clinic.

"We had our own nursing staff and we had our own anesthesiologists. There was never any reuse of needles, syringes or any of that," said Komanduri, a psychiatrist, who's been in Las Vegas since 1994.

"We had single-use vials. As soon as it was done, a vial's contents were washed into a sink with two nurses watching," he said.

The Southeast Clinic, at Pecos and Flamingo roads, was closed in 2006 because its business occupancy permit allowed for only a certain number of procedures that failed to accommodate the area's growing veteran population.

Currently, most local veterans in need of colonoscopies or endoscopies are being referred to Dr. Osama Haikal or Dr. Joseph Fayad. They also have an option to go other doctors in southern California but few want to travel there, Komanduri said.

"They want all hepatitis (cases) tested before we send them a patient anymore," he said.

A Nellis base spokesman, Staff Sgt. Travis Edwards, said 1,800 airmen on active duty, in the National Guard, Reserve, dependents, retirees and veterans were notified on March 5 to come to the base for blood tests for hepatitis C, B and HIV.

"Nothing is conclusive yet. We don't have any confirmation" of positive tests, he said Thursday.

Edwards said TriWest Healthcare Alliance out of Phoenix, the regional provider for the Defense Department's health care entitlement, TRICARE, has terminated its contracts with the Las Vegas facilities in question "due to the alleged, unsafe practices that are currently being investigated."

Disabled American Veterans Department of Nevada Adjutant Bill Anton said he's thankful that only two out of more than 700 veterans who have been tested since the health alert are positive for hepatitis.

"We're sorry that there are any but this is not the VA's fault. We're using the local medical facilities and physicians with specialties that the VA and the Air Force have a shortage (of)," he said.

The VA is building a $600 million hospital, nursing home and outpatient center at Pecos Road and the Las Vegas Beltway. The complex in North Las Vegas is expected to be operational by mid-2011.

Contact reporter Keith Rogers at krogers@ reviewjournal.com or (702) 383-0308.