Infections Among Homeless Could Fuel Wider Epidemics -- Study

A study published online Monday found that homeless people have dramatically higher rates of TB, HIV, and hepatitis C virus (HCV) infection, which could lead to community epidemics.

"Infections in homeless people can lead to community infections and are associated with malnutrition, long periods of homelessness, and high use of medical services," said Seena Fazel, who led the study and is a senior research fellow in clinical science at the University of Oxford.

Estimates place the homeless population at 650,000 people in the United States, 380,000 in Britain, and 100 million worldwide.

Fazel and his team analyzed more than 40 research papers on HIV, HCV, and TB among homeless people from 1984 to 2012. Among the U.S. homeless population, TB rates were at least 46 times higher than in the general population. Rates also were elevated for HCV (more than four times higher) and HIV (one to 20 times higher). Among Britain's homeless residents, TB rates were 34 times those of the general population, and HCV was almost 50 times higher. HIV rates for the homeless in Britain were not available.

Similar patterns were found in most other countries where data were available, including France, India, Sweden, Ireland, and Brazil.

In addition to the three diseases that were the study's focus, the researchers noted that the homeless also have high rates of hepatitis A and B, diphtheria, foot problems, and skin infections.

Fazel said his findings suggest that focusing on the homeless as a group at very high risk for infectious diseases "could have pronounced effects on public health."

[PNU editor's note: "Prevalence of Tuberculosis, Hepatitis C Virus and HIV in Homeless People: A Systematic Review and Meta-Analysis," was published in the Lancet Infectious Diseases (2012;doi:10.1016/S1473-3099(12)70177-9).]

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