Epidemic fears over homeless infection rates

Homeless people across the world have dramatically higher rates of infection with tuberculosis (TB), HIV and hepatitis C, and could fuel community epidemics that cost governments dear, a study has shown.

With an estimated 650,000 homeless people in the US and around 380,000 in Britain, experts said high levels of infection would not only cause yet more poverty and distress for those without homes, but could also become a wider problem.

“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, of the University of Oxford, who led the study.

Mr Fazel and his team analysed more than 40 research papers on HIV, hepatitis C, and TB among homeless people from 1984 to 2012 for the study, published in the Lancet Infectious Diseases journal.

They found that in the US, for example, TB rates were at least 46 times greater in the homeless than in the general population, and the prevalence of hepatitis C viral infection was more than four times higher.

In Britain, TB rates were about 34 times higher in homeless people than in the general population, and the prevalence of hepatitis C viral infection was nearly 50 times higher.

For HIV, rates of infection were typically between one and 20 times higher in homeless people in the US than the general population.

Mr Fazel said his findings suggested the best way to fight back against these and other diseases was to focus on the homeless as one of the highest risk groups.