Abstracts of the 2025 Annual Meeting of the ALEH
More infoHepatitis C virus (HCV) poses a global health threat, especially among people experiencing homelessness (PEH), but data from Latin America are scarce.
Materials and MethodsWe prospectively screened 800 PEH in Santiago, Chile, using rapid HCV antibody tests with confirmatory RNA testing. Sociodemographic and clinical data were collected through structured interviews.
ResultsWe identified four HCV-positive individuals, corresponding to a prevalence of 0.5%. The median age was 44.1 years (±14.8), and 39.7% of the cohort were women. At screening, 63.5% lived on the street and 36.5% in shelters. All four HCV-positive individuals were Chilean; three were men. Two had tattoos and reported high-risk sexual behavior; one had a history of blood transfusion. Three reported heavy alcohol use and two used cocaine, though none had a history of injection drug use. Two had cirrhosis. All received support from social services and engaged in informal work. None were coinfected with HBV or HIV. Only one patient initiated and completed DAA therapy, achieving sustained virologic response. Barriers to treatment included lack of insurance, referral delays, and loss to follow-up. No sociodemographic factors were statistically associated with HCV infection in univariate analysis (e.g., age OR 1.03, p=0.385; male sex OR 0.83, p=0.888; street vs. shelter OR 1.09, p=0.942).
ConclusionsHCV prevalence among PEH in Santiago was low, with risk factors differing from high-prevalence settings. Structural barriers remain the main obstacle to treatment, underscoring the need for targeted interventions within elimination strategies.
