Hepatitis C among people experiencing homelessness in Chile: prevalence and associated factors

OBJECTIVE: Hepatitis C virus (HCV) infection remains an important public health concern among people experiencing homelessness (PEH), yet data from Latin America are limited. We aimed to estimate HCV prevalence and describe associated risk factors and linkage to care in this population. MATERIALS AND METHODS: We conducted a retrospective study of 800 PEH in Santiago, Chile. Participants underwent rapid HCV antibody screening followed by confirmatory RNA testing. Standardized data on sociodemographic characteristics and potential risk factors were collected. RESULTS: Four participants tested positive for HCV, corresponding to a prevalence of 0.5%. Reported exposures among HCV-positive individuals included tattoos, high-risk sexual behaviors, previous blood transfusion, and cocaine use; none reported intravenous drug use. Linkage to care was limited, with only one individual (25%) initiating direct-acting antiviral therapy. Barriers included lack of health insurance coverage, administrative obstacles, unstable living conditions, and loss to follow-up. CONCLUSIONS: HCV prevalence in this cohort was low. However, distinct risk profiles and important gaps in treatment access were identified. These findings support the need for targeted microelimination strategies and strengthened linkage-to-care pathways for PEH in Latin America.