June 13, 2012
Among 534 homeless adults surveyed at 41 shelters and meal programs in downtown Los Angeles' Skid Row, 26.7 percent tested positive for hepatitis C virus, a new study found. Of those with HCV, 46.1 percent were unaware of their infection. However, among those who were aware, almost none had ever been treated for the infection. The public health system could face a major financial challenge as such infections progress to cirrhosis and end-stage liver disease, the research suggests.
The study, conducted between June 2003 and February 2004, asked participants about their HCV status, drug, sexual, and other behaviors. Blood samples were collected for testing. HCV prevalence was significantly higher among those who had injected drugs, had less education, were at least 40 years old, or were former prisoners. Among those who had ever injected drugs, HCV prevalence was 77.6 percent, compared with 13.6 percent of those who had never injected. Sexual behaviors had no significant association with HCV status. Overall, 4 percent tested HIV-positive.
"Homeless adults need interventions that include HCV education, counseling, voluntary testing, and treatment services," concluded Dr. Lillian Gelberg, of the University of California-Los Angeles Geffen School of Medicine, and colleagues. "HCV prevention and treatment programs could be modeled after relevant successful interventions developed for US homeless persons with HIV/AIDS."
[PNU editor's note: The study, "Prevalence, Distribution, and Correlates of Hepatitis C Virus Infection Among Homeless Adults in Los Angeles," was published in Public Health Reports (2012;127:407-421).]