Chronic liver disease in homeless individuals and performance of non‐invasive liver fibrosis and injury markers: VALID study

摘要

Abstract Background/aims Community‐based assessment and management of chronic liver disease (CLD) in people who are homeless (PWAH) remain poorly described. We aimed to determine prevalence/predictors of CLD in PWAH and assess the performance of non‐invasive liver fibrosis and injury markers. Methods The Vulnerable Adult LIver Disease (VALID) study provided a “one‐stop” liver service based at homeless hostels. Our primary outcome was the prevalence of clinically significant hepatic fibrosis (CSHF; liver stiffness measurement (LSM) ≥8?kPa). Results Total individuals recruited were 127, mean?±?SD age 47?±?9.4?years, 50 (95 CI 41‐59) and 39 (95 CI 31‐48) having alcohol dependence and a positive HCV RNA respectively. CSHF was detected in 26 (95 CI 17‐35), independent predictors being total alcohol unit/week (OR 1.01, 95 CI 1.00‐1.02, P?=?.002) and HCV RNA positivity (OR 2.93, 95 CI 1.12‐7.66, P?=?.029). There was moderate agreement between LSM and Enhanced Liver Fibrosis (ELF) score (kappa 0.536, P?