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

Francisco Idalsoaga; Luis Antonio Diaz; Hanna Blaney; Camila Picchio; Fernanda Contreras; Barbara Ricouz; David Salinas; Valentina Espinoza; Pía Venegas; Miguel Harfagar; Ingrid Santander; María Paz Medel; Carolina Ramirez-Cadiz; Marco Arrese; Alejandro Soza; Abe Oudshoorn; Juan Pablo Arab

doi:10.47892/rgp.2026.462.2241

Authors

Francisco Idalsoaga Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Fundacion Salud Calle, Santiago, Chile. https://orcid.org/0000-0001-5607-0698
Luis Antonio Diaz Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; MASLD Research Center, University of California San Diego, San Diego, California, USA. https://orcid.org/0000-0002-8540-4930
Hanna Blaney Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. https://orcid.org/0000-0003-4919-9519
Camila Picchio Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.
Fernanda Contreras Escuela de Medicina, Universidad de Valparaiso, Santiago, Chile. https://orcid.org/0009-0004-2453-766X
Barbara Ricouz Fundacion Salud Calle, Santiago, Chile. https://orcid.org/0009-0001-2866-7267
David Salinas Fundacion Salud Calle, Santiago, Chile; Hospital Padre Hurtado, Santiago, Chile. https://orcid.org/0009-0006-8779-2275
Valentina Espinoza Fundacion Salud Calle, Santiago, Chile; Global Health and Development, University College, London, UK. https://orcid.org/0009-0006-6122-0658
Pía Venegas Fundacion Salud Calle, Santiago, Chile. https://orcid.org/0000-0003-2136-3022
Miguel Harfagar Fundacion Salud Calle, Santiago, Chile. https://orcid.org/0009-0003-4631-6676
Ingrid Santander Fundacion Salud Calle, Santiago, Chile.
María Paz Medel Departamento de Medicina Familiar, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile. https://orcid.org/0000-0001-8360-7307
Carolina Ramirez-Cadiz Department of Anesthesiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. https://orcid.org/0000-0002-6805-0560
Marco Arrese Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile. https://orcid.org/0000-0002-0499-4191
Alejandro Soza Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile. https://orcid.org/0000-0002-1136-9554
Abe Oudshoorn Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada. https://orcid.org/0000-0003-0277-8724
Juan Pablo Arab Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. https://orcid.org/0000-0002-8561-396X

DOI:

https://doi.org/10.47892/rgp.2026.462.2241

Keywords:

Liver Diseases, Health Inequities, Ill-Housed Person, Hepatitis, Viral, Human

Abstract

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 linkageto-care pathways for PEH in Latin America.

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