Cheung Ramsey C, Hanson Aspasia K, Maganti Kalyani, Keeffe Emmet B, Matsui Suzanne M
Division of Gastroenterology and Hepatology, VA Palo Alto Health Care System, Palo Alto, California 94304, USA.
J Clin Gastroenterol. 2002 Apr;34(4):476-80. doi: 10.1097/00004836-200204000-00021.
To determine the prevalence of four common infectious diseases-hepatitis B, hepatitis C, human immunodeficiency virus (HIV), and tuberculosis-as well as co-infection rates and risk factors in a homeless population.
The prevalence of infectious diseases, especially viral hepatitis, among the homeless population is largely unknown.
This study consists of a retrospective analysis of the history and laboratory data collected from all homeless veterans admitted to a Veterans Administration (VA) domiciliary from May 1995 to March 2000.
Of the homeless veterans admitted to a VA domiciliary program, 597 of 829 were screened for markers of all four infectious diseases. The overall prevalence of anti-hepatitis C virus (HCV) antibody, and positive result for purified protein derivative (PPD), anti-HIV antibody, and hepatitis B surface antigen (HbsAg) were 41.7%, 20.6%, 1.84% and 1.17%, respectively. At least one of the four markers was positive in 52.6% and more than one in 12%. Co-infection with HCV occurred commonly in veterans who were positive for anti-HIV (72.7%) and HBsAg (57.1%). Four self-reported major risk factors (intravenous drug use, alcohol abuse, previous imprisonment, and prior stay in a shelter) were evaluated. Multivariate analysis indicates that intravenous drug use and anti-HBs reactivity are independent risk factors for HCV infection, HCV infection for anti-hepatitis B surface antibody reactivity, and older age for PPD positivity.
Chronic hepatitis C and co-infections are common among the homeless population. Patients infected with HIV and hepatitis B virus frequently are co-infected with HCV. Infections frequently are associated with certain identifiable risk factors.
确定四种常见传染病——乙型肝炎、丙型肝炎、人类免疫缺陷病毒（HIV）和结核病——在无家可归人群中的患病率、合并感染率及危险因素。
无家可归人群中传染病，尤其是病毒性肝炎的患病率很大程度上未知。
本研究对1995年5月至2000年3月入住退伍军人管理局（VA）疗养院的所有无家可归退伍军人的病史和实验室数据进行回顾性分析。
在入住VA疗养院项目的无家可归退伍军人中，829人中有597人接受了所有四种传染病标志物的筛查。抗丙型肝炎病毒（HCV）抗体、纯化蛋白衍生物（PPD）阳性结果、抗HIV抗体和乙型肝炎表面抗原（HbsAg）的总体患病率分别为41.7%、20.6%、1.84%和1.17%。四种标志物中至少一种呈阳性的比例为52.6%，一种以上呈阳性的比例为12%。抗HIV阳性（72.7%）和HBsAg阳性（57.1%）的退伍军人中常见HCV合并感染。评估了四个自我报告的主要危险因素（静脉吸毒、酗酒、既往监禁和曾在收容所居住）。多变量分析表明，静脉吸毒和抗-HBs反应性是HCV感染的独立危险因素，HCV感染是抗乙型肝炎表面抗体反应性的危险因素，年龄较大是PPD阳性的危险因素。
慢性丙型肝炎和合并感染在无家可归人群中很常见。感染HIV和乙型肝炎病毒的患者常合并感染HCV。感染常与某些可识别的危险因素相关。
