Hepatitis A among people experiencing homelessness: a case series, Curitiba, Paraná State, Brazil, 2023-2024

To describe hepatitis A cases among people experiencing homelessness in Curitiba, Paraná State, Brazil, in 2023-2024.

This case series included people experiencing homelessness who were reported with hepatitis A in the Notifiable Diseases Information System between November 1, 2023, and May 29, 2024, in Curitiba. This population was identified by reviewing electronic medical records and the registry database of the Consultório na Rua [Street Outreach Clinic] team. Sociodemographic, clinical, and laboratory variables were extracted.

Of 281 reported cases, 18 (6.4%) occurred among individuals experiencing homelessness; 16 were male. The mean age was 31±7 years. Regarding substance use in this population, 17 individuals reported crack cocaine use and 14 reported alcohol use. Mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 1,290.94 (±1,144.82) U/L and 1,558.13 (±1,050.00) U/L, respectively. The mean total bilirubin level at clinical presentation was 5.29 (±3.59) mg/dL, and jaundice was present in 55.6% of cases. Two deaths were recorded among the 18 cases in individuals experiencing homelessness (mortality: 11.1%), compared with three deaths among the remaining 263 reported cases (mortality: 1.1%).

Symptoms of acute liver failure were observed in hepatitis A cases among people experiencing homelessness, all of whom required hospitalization; deaths were also reported.