{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:20:27Z","timestamp":1784308827176,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Urban homeless populations in the UK have been shown to have high rates of active tuberculosis, but less is known about the prevalence of latent tuberculosis infection (LTBI). This study aimed to estimate the prevalence of LTBI among individuals using homeless hostels in London.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a cross-sectional survey with outcome follow-up in homeless hostels in London. Our primary outcome was prevalence of LTBI. Recruitment for the study took place between May 2011 and June 2013. To estimate an LTBI prevalence of 10% with 95% CIs between 8% and 13%, we required 500 participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>491\/804 (61.1%) individuals agreed to be screened. The prevalence of LTBI was 16.5% (81\/491; 95%\u2009CI 13.2 to 19.8). In UK-born individuals, a history of incarceration was associated with increased risk of LTBI (OR 3.49; 95%\u2009CI 1.10 to 11.04; P=0.018) after adjusting for age, length of time spent homeless and illicit drug use. Of the three subjects who met English treatment guidelines for LTBI at the time of the study, none engaged with services after referral for treatment. Prevalence of past hepatitis B infection was 10.4% (51\/489; 95%\u2009CI 7.7 to 13.1), and 59.5% (291\/489; 95%\u2009CI 55.1 to 63.9) of individuals were non-immune. Prevalence of current hepatitis C infection was 10.4% (51\/489; 95%\u2009CI 7.8 to 13.1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates the high prevalence of LTBI in homeless people in London and the associated poor engagement with care. There is a large unmet need for LTBI and hepatitis C infection treatment, and hepatitis B vaccination, in this group.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thoraxjnl-2016-209579","type":"journal-article","created":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T17:17:05Z","timestamp":1517246225000},"page":"557-564","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["High prevalence of latent tuberculosis and bloodborne virus infection in a homeless population"],"prefix":"10.1136","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-0816","authenticated-orcid":false,"given":"Robert W","family":"Aldridge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Hemming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K","family":"Yates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Ferenando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Possas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Garber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Geretti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy Daniel","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Lipman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Story","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,1,29]]},"reference":[{"key":"2020050723434015000_73.6.557.1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.065409"},{"key":"2020050723434015000_73.6.557.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.12.s2.4.x"},{"key":"2020050723434015000_73.6.557.3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-6-47"},{"key":"2020050723434015000_73.6.557.4","unstructured":"Crisis. Homelessness monitor. https:\/\/www.crisis.org.uk\/ending-homelessness\/homelessness-knowledge-hub\/homelessness-monitor\/ (accessed 3 Jul 2017)."},{"key":"2020050723434015000_73.6.557.5","unstructured":"Homeless Link. Annual review of single homelessness support in England. http:\/\/www.homeless.org.uk\/facts\/our-research\/annual-review-of-single-homelessness-support-in-england (accessed 3 Jul 2017)."},{"key":"2020050723434015000_73.6.557.6","unstructured":"GOV.UK. Tuberculosis (TB): regional and devolved administration reports. https:\/\/www.gov.uk\/government\/publications\/tuberculosis-tb-regional-reports (accessed 3 Jul 2017)."},{"key":"2020050723434015000_73.6.557.7","first-page":"257","article-title":"Recent developments in treatment of latent tuberculosis infection","volume":"133","author":"Menzies","year":"2011","journal-title":"Indian J Med Res"},{"key":"2020050723434015000_73.6.557.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1104875"},{"key":"2020050723434015000_73.6.557.9","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200510-1666ST"},{"key":"2020050723434015000_73.6.557.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5376"},{"key":"2020050723434015000_73.6.557.11","unstructured":"National Institute for Health and Clinical Excellence. Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control (clinical guideline 33). http:\/\/guidance.nice.org.uk\/CG33 (accessed 18 Dec 2009)."},{"key":"2020050723434015000_73.6.557.12","unstructured":"NICE. Tuberculosis: identification and management in under-served groups | Guidance and guidelines. https:\/\/www.nice.org.uk\/guidance\/ph37 (accessed 11 Jul 2016)."},{"key":"2020050723434015000_73.6.557.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2003.10.004"},{"key":"2020050723434015000_73.6.557.14","unstructured":"Abbott. Abbott m2000 RealTime System. Abbott M2000 Realt. Syst. 2015 https:\/\/www.abbottmolecular.com\/us\/products\/instrumentation-automation\/realtime-pcr\/m2000-sp-rt.html (accessed 11 Jul 2016)."},{"key":"2020050723434015000_73.6.557.15","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70177-9"},{"key":"2020050723434015000_73.6.557.16","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-22"},{"key":"2020050723434015000_73.6.557.17","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.3201\/eid1507.080410","article-title":"Latent tuberculosis and active tuberculosis disease rates among the homeless, New York, New York, USA, 1992-2006","volume":"15","author":"McAdam","year":"2009","journal-title":"Emerg Infect Dis"},{"key":"2020050723434015000_73.6.557.18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-720"},{"key":"2020050723434015000_73.6.557.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(02)00583-4"},{"key":"2020050723434015000_73.6.557.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2012.08.010"},{"key":"2020050723434015000_73.6.557.21","unstructured":"GOV.UK. Hepatitis C in the UK. https:\/\/www.gov.uk\/government\/publications\/hepatitis-c-in-the-uk (accessed 11 Jul 2016)."},{"key":"2020050723434015000_73.6.557.22","doi-asserted-by":"crossref","unstructured":"NICE. Tuberculosis | Guidance and guidelines | NICE guidelines [NG33]. https:\/\/www.nice.org.uk\/guidance\/ng33 (accessed 11 Jul 2016).","DOI":"10.7748\/ldp.19.7.11.s12"},{"key":"2020050723434015000_73.6.557.23","unstructured":"Homeless Link. Homelessness and health research. http:\/\/www.homeless.org.uk\/facts\/our-research\/homelessness-and-health-research (accessed 5 Aug 2016)."},{"key":"2020050723434015000_73.6.557.24","doi-asserted-by":"publisher","DOI":"10.1100\/2012\/840421"},{"key":"2020050723434015000_73.6.557.25","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdg088"},{"key":"2020050723434015000_73.6.557.26","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-44"},{"key":"2020050723434015000_73.6.557.27","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.11.0773"},{"key":"2020050723434015000_73.6.557.28","unstructured":"GOV.UK. Statutory homelessness January to March 2016 and homelessness prevention and relief 2015 to 2016: England. https:\/\/www.gov.uk\/government\/statistics\/statutory-homelessness-january-to-march-2016-and-homelessness-prevention-and-relief-2015-to-2016-england (accessed 5 Aug 2016)."},{"key":"2020050723434015000_73.6.557.29","unstructured":"GOV.UK. Rough sleeping in England: autumn 2015. https:\/\/www.gov.uk\/government\/statistics\/rough-sleeping-in-england-autumn-2015 (accessed 5 Aug 2016)."},{"issue":"Suppl 3","key":"2020050723434015000_73.6.557.30","doi-asserted-by":"crossref","first-page":"S93","DOI":"10.1016\/S0140-6736(13)62518-0","article-title":"Slopes and cliffs in health inequalities: comparative morbidity of housed and homeless people","volume":"382","author":"Story","year":"2013","journal-title":"The Lancet"},{"key":"2020050723434015000_73.6.557.31","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp160"},{"key":"2020050723434015000_73.6.557.32","doi-asserted-by":"publisher","DOI":"10.1177\/003335491412900101"},{"key":"2020050723434015000_73.6.557.33","unstructured":"GOV.UK. Tuberculosis (TB): collaborative strategy for England. https:\/\/www.gov.uk\/government\/publications\/collaborative-tuberculosis-strategy-for-england (accessed 8 May 2015)."},{"key":"2020050723434015000_73.6.557.34","unstructured":"QIAGEN. Interpretation criteria for QuantiFERON-TB Gold (Table 2 and 3). QuantiFERONTB Gold. 2016 http:\/\/www.quantiferon.com\/wp-content\/uploads\/2017\/04\/English_QFT_ELISA_R04_082016.pdf (accessed 11 Jul 2016)."},{"key":"2020050723434015000_73.6.557.35","unstructured":"Department of Health. Getting ahead of the curve: a strategy for combating infectious diseases (including other aspects of health protection). 2002 http:\/\/webarchive.nationalarchives.gov.uk\/+\/dh.gov.uk\/en\/publicationsandstatistics\/publications\/publicationspolicyandguidance\/dh_4007697 (accessed 11 Jul 2016)."}],"container-title":["Thorax"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/thoraxjnl-2016-209579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T06:00:52Z","timestamp":1601100052000},"score":1,"resource":{"primary":{"URL":"https:\/\/thorax.bmj.com\/lookup\/doi\/10.1136\/thoraxjnl-2016-209579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,29]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,5,16]]},"published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1136\/thoraxjnl-2016-209579"],"URL":"https:\/\/doi.org\/10.1136\/thoraxjnl-2016-209579","relation":{},"ISSN":["0040-6376","1468-3296"],"issn-type":[{"value":"0040-6376","type":"print"},{"value":"1468-3296","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,29]]}}}