P0330 HIGH PREVALENCE OF HEPATITIS C VIRUS(HCV) INFECTION IN HOMELESS CAREGIVERS IN BALTIMORE

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Introduction: Although HCV infection in adults is associated with injection drug use, which is a common problem in homeless adults, and although up to one-third of people living in homeless shelters are <age 18 years, there are no data concerning the prevalence of HCV infection in homeless US caregivers. Methods: Accordingly, we examined the prevalence of HCV antibody positivity in homeless caregivers in Baltimore. During the period from 10/11/01–7/2/03, 124 caregivers of 252 children were tested for anti-HCV antibody, using an FDA-approved fin-gerstick testing system developed by Home Access Corp (Hoffman Estates, Ill) in which blood is obtained using a sterile lancet and collected on filter paper, extracted and tested with the Ortho HCV Version 3.0 Elisa test system with confirmatory testing by Chiron Riba HCV 3.0 strip immunoblot assay. Results: 24 caregivers (19%) were HCV positive; the majority (58%) did not know they were HCV positive until they were informed through the study (p<0.0001). Characteristics associated with positive anti-HCV status vs. anti-HCV negative status were as follows:age (y)40.5 +/− 7.2 vs. 32.3 +−8.9, p=0.0012; male 13% vs. 1%, p=0.0227;didn’t finish high school 27% vs.13%, p=0.0463; ever used heroin 21% vs. 6%, p=0.0368; ever used cocaine/crack 29% vs. 9%, p=0.0151; sexual partner with hepatitis 88% vs.12%, p= 0.0001; HIV+ sexual partner 26% vs 1%, p=0.0001; ever injected street drugs 81% vs. 19%, p=0.0001. Conclusion: HCV infection is alarmingly high among homeless caregivers in Baltimore and is strongly associated with failure to complete high school, use of heroin, cocaine, crack, and/or other injected street drugs and with sexual behavior. Extrapolation of these results to the entire US would indicate that up to 600,000 homeless children are living with an HCV-infected care-giver. Public policies are urgently needed to focus on the special needs of these unfortunate children.

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