Hepatitis B among homeless and other impoverished US military veterans in residential care in Los Angeles

Findings are presented for a cross-sectional study of serological markers o r hepatitis B virus (HBV) infection in an underserved population-impoverish ed veterans of the US armed forces in a Veterans Administration (VA) reside ntial program in the US. We examine the demographic, background, and risk f actors associated with HBV infection ill this high-risk population. This pa per presents a secondary analysis of cross-sectional survey and clinical da ta for 370 male veterans who were residents of a domiciliary care program f or homeless veterans in Los Angeles, using chi (2), Fisher's Exact, and log istic regression analysis. About one-third (30.8%) of the sample tested positive for current or past H BV infection (ie, seropositive for either the HBV core antibody or surface antigen). After multivariate analysis, rates of HBV were significantly high er among veterans who were older, non-white, or who had a history of regula r heroin use (a proxy measure for injection drug use), drug overdose, or dr ug detoxification treatment. The rate of current or past HBV infection amon g veterans in this sample (30.8%) was high compared to an estimated 5% to 8 % of the general US population. Also, 3% or the sample were currently infec ted with HBV. Strategies for intervention include broader screening, immuni zation, and treatment interventions with this high-risk group.