Risk factors and seroprevalence of markers for hepatitis A, B and C in persons subject to homelessness in inner Sydney.
OBJECTIVE
To determine the seroprevalence of hepatitis A, B and C and the prevalence of risk factors for blood-borne infections in persons subject to homelessness attending a medical clinic in inner Sydney.


METHODS
During 2003-05, 201 clients were enrolled in a prospective study to determine the acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A and B. On enrolment, clients completed a risk factor assessment questionnaire and undertook pre-vaccination serological screening for hepatitis A, B and C.


RESULTS
Forty-five per cent (85/188) of clients were positive for anti-HCV antibodies; 32% (60/189) showed evidence of past infection with HBV (anti-HBc); and 48% (89/189) were positive for anti-HAV antibodies. It was not uncommon for clients to have multiple markers of hepatitis. A past history of injecting drug use was significantly associated with markers for hepatitis B and C; age predicted presence of anti-HAV. A verbal history of infection appeared more reliable for hepatitis C, but considerably less so for hepatitis A and B.


CONCLUSIONS
Persons subject to homelessness are at risk of blood-borne infection. The seroprevalence of markers for hepatitis B and C are higher than in the general population.


CONCLUSIONS
Despite the high proportion of clients with serological markers for hepatitis A and B, at least 69% of clients could potentially benefit from hepatitis A and/or B vaccination.
Poulos
Roslyn
R
School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales 2052. r.poulos@unsw.edu.au
Ferson
Mark
M
Orr
Karen
K
Lucy
Adrienne
A
Botham
Susan
S
McCarthy
Michele
M
Stern
Jerome
J
Dixon
Julie
J
Murray
Carolyn
C
Polis
Suzanne
S
D000293:Adolescent; D000328:Adult; D006505:Hepatitis / Q000453:epidemiology* / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006703:Ill-Housed Persons; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires
D006508:Hepatitis Antibodies