Prevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Homeless and Nonhomeless United States Veterans

Noska, Amanda; Belperio, Pamela S.; Loomis, Timothy P.; O’Toole, Thomas; Backus, Lisa I.

doi:10.1093/cid/cix295

Cited by 55 publications

(37 citation statements)

References 27 publications

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“…While the higher prevalence of HCV in homeless populations is acknowledged by the HCV Guidance Panel, the homeless are not specifically named as a group for testing at this time. Although several studies have noted prevalence rates above 10% in several homeless populations in the United States, it is believed that the risk is often due to high rates of substance use disorders, which would be captured by the HCV Panel guidance to test injection and intranasal drug users[ 30 ]. Sexual transmission of HCV is generally considered inefficient except among HIV-infected MSM; therefore, guidance related to sexual transmission categories for the general United States population have not been included as an HCV testing category[ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of hepatitis C virus testing recommendations in high-income countries

Irvin

Ward

Agee

et al. 2018

WJH

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AIMTo investigate hepatitis C virus (HCV) testing recommendations from the United States and other high-income countries.METHODSA comprehensive search for current HCV testing recommendations from the top quartile of United Nations Human Development Index (HDI) countries (very high HDI) was performed using Google and reviewed from May 1 - October 30, 2014 and re-reviewed April 1 - October 2, 2017.RESULTSOf the 51 countries identified, 16 had HCV testing recommendations from a government body or recommendations issued collaboratively between a government and a medical organization. Of these 16 countries, 15 had HCV testing recommendations that were primarily risk-based and highlight behaviors, exposures, and conditions that are associated with HCV transmission in that region. In addition to risk-based testing, the HCV Guidance Panel (United States) incorporates recommendations for a one-time test for individuals born during 1945-1965 (the birth cohort) without prior ascertainment of risk into their guidance. In addition to the United States, six other countries either have an age-based testing recommendation or recommend one-time testing for all adults independent of risk factors typical of the region.CONCLUSIONThis review affirmed the similarities of the HCV Guidance Panel’s guidance with those of recommendations from very high HDI countries.

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Section: Discussionmentioning

confidence: 99%

Comparison of hepatitis C virus testing recommendations in high-income countries

Irvin

Ward

Agee

et al. 2018

WJH

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“…In comparison to the general population, people who are homeless experience poorer health and health-related outcomes. People who are homeless are at greater risk of developing a range of mental and physical illnesses, including vaccine-preventable diseases such as hepatitis (Hosseini & Ding, 2018;Noska et al, 2017;Peak et al, 2019), pneumococcal disease (Lemay et al, 2019;McKee et al, 2018;Mosites et al, 2019) and tuberculosis (Bamrah et al, 2013;Khan et al, 2011;Lee et al, 2013;Romaszko et al, 2013). Once ill, people who are homeless have a greater likelihood of hospitalisation, intensive care unit (ICU) admission, and death (Lewer et al, 2020).…”

Section: Health Disparities and Vaccine-preventable Diseases In Peoplmentioning

confidence: 99%

Interventions to Deliver Vaccination to, and Improve Vaccination Rates in, People who are Homeless

McCosker

Ware

Downes

2020

ssp

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Background: In comparison to the general population, people who are homeless have poorer health and health-related outcomes, including for vaccine-preventable diseases. Vaccination is safe, effective and cost-effective, and many vaccination guidelines specifically recommend vaccination in people who are homeless. This systematic review will identify interventions which are effective in delivering vaccination to, and/or at improving vaccination rates in, people who are homeless. Methods/Design: This systematic review is presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be undertaken on eight electronic databases, using combinations of search terms and subject headings or index terms. Citation chaining will also be undertaken. Literature will be screened for relevance against inclusion/exclusion criteria firstly by title/abstract and secondly by full text. The selected studies will be assessed for quality using an evidence-based tool appropriate to their methods. Data relevant to the topic will be extracted and examined using meta-analysis and narrative synthesis. Discussion: This systematic review will address an important gap in the literature about vaccination in people who are homeless. The review’s findings are particularly relevant considering the current coronavirus disease (COVID-19) pandemic, which is likely to be managed through vaccination.

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“…However, the prevalence of chronic HBV infection among US veterans is estimated to be low (<1%). 33 Finally, we might have underestimated the number of persons with diagnosed chronic HBV infection because of the possibility of overmatching laboratory reports and death certificate information in the surveillance system. Matching reports of hepatitis B is more challenging than matching reports for other conditions, primarily because of the high percentage of persons of Asian descent, who often have commonly shared, shorter names that are harder to definitively match than longer, less common names, which could lead to overmatching of reports of chronic HBV infection and overestimating the number of deaths in this population.…”

Section: Limitationsmentioning

confidence: 99%

Surveillance-Based Estimate of the Prevalence of Chronic Hepatitis B Virus Infection, New York City, 2016

2019

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Objectives: Chronic hepatitis B virus (HBV) infection is a lifelong infection that can cause serious liver damage and liver cancer. The last surveillance-based prevalence estimate of chronic HBV infection in New York City was 1.2% in 2008; however, it did not account for persons with undiagnosed infection. The objective of this study was to calculate the prevalence of chronic HBV infection, including undiagnosed infection, for 2016 by using surveillance data and literature-based information. Methods: We calculated the number of persons with diagnosed chronic HBV infection (2000-2016) who were alive and living in New York City in 2016 by using routine surveillance data. We estimated the percentage of persons with undiagnosed chronic HBV infection by using birth region–specific percentages from the literature, weighted by the proportion of the New York City population with diagnosed chronic HBV infection from the same birth region. We identified minimum, maximum, and most likely values for the percentage with undiagnosed chronic HBV infection to generate 95% certainty limits (CLs) of the prevalence estimate. Results: The prevalence of chronic HBV infection in 2016, including undiagnosed infection, in New York City was 2.7% (95% CL, 2.2%-3.6%), representing approximately 230 000 persons. The prevalence of diagnosed chronic HBV infection was 1.5%. The estimated prevalence among non–US-born residents was 6.9% (95% CL, 5.4%-8.9%). Conclusions: The current burden of chronic HBV infection in New York City, especially for non–US-born residents, is substantial. A renewed focus and dedication of resources is required to increase the number of new diagnoses and improve provider capacity to care for the large number of persons with chronic HBV infection.

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Prevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Homeless and Nonhomeless United States Veterans

Cited by 55 publications

References 27 publications

Comparison of hepatitis C virus testing recommendations in high-income countries

Comparison of hepatitis C virus testing recommendations in high-income countries

Interventions to Deliver Vaccination to, and Improve Vaccination Rates in, People who are Homeless

Surveillance-Based Estimate of the Prevalence of Chronic Hepatitis B Virus Infection, New York City, 2016

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