Year 2020 / Volume 112 / Number 7
Original
Patients with hepatitis C lost to follow-up: ethical-legal aspects and search results

532-537

DOI: 10.17235/reed.2020.7077/2020

Irene Andaluz García, María del Mar Arcos Rueda, María Dolores Montero Vega, Pilar Castillo Grau, Luz Martín Carbonero, Javier García-Samaniego Rey, Miriam Romero Portales, Araceli García Sánchez, Carmen Busca Arenzana, Juan González García, María Luisa Montes Ramírez, Antonio Olveira Martín,

Abstract
Introduction: data on the prevalence and characteristics of hepatitis C patients lost to follow-up are lacking. In addition, the identification of this population clashes with data protection regulations. Methods: the identification and contact protocol was submitted to the Health Care Ethics Committee. The protocol was based on anti-HCV serology test results for 2010-2018, which were obtained from the Microbiology Department. In addition, the situation of the patients in the hospital and regional database was analyzed, based on the following classification: a) chronic hepatitis C, if the last HCV RNA determination was positive; b) cured hepatitis C, if the last HCV RNA determination was negative after 12 weeks of treatment; and c) possible hepatitis C, if anti-HCV antibodies were positive with no result for HCV RNA. Lost patients were defined as those with chronic or possible hepatitis C and no follow-up in the Digestive Diseases or Internal Medicine Departments. The patients were contacted by postal mail and then by telephone, so that they could be offered treatment. Results: the Ethics Committee considered that the protocol fulfilled the bioethical principles of autonomy, beneficence, non-maleficence and justice and that contact was ethically desirable. From 4,816 positive anti-HCV serology results, 677 patients were identified who were lost to follow-up (14.06 %; 95 % CI, 13.2-15.2). The mean age was 54 years, 61 % were male, 12 % were foreign born and 95 % were mono-infected. The study of each serology result took 1.3 minutes. One-quarter (25 %) of the losses corresponded to the Digestive Diseases and Internal Medicine Departments. Of the 677 losses, serology testing had only been ordered for 449 patients (66.3 %) and the remaining 228 (33.7 %) also had a positive HCV RNA result. Conclusion: a large number of patients with hepatitis C are lost to follow-up. Searching for and contacting these patients is legally and ethically viable.
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Andaluz García I, Arcos Rueda M, Montero Vega M, Castillo Grau P, Martín Carbonero L, García-Samaniego Rey J, et all. Patients with hepatitis C lost to follow-up: ethical-legal aspects and search results. 7077/2020


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Publication history

Received: 27/03/2020

Accepted: 21/04/2020

Online First: 24/06/2020

Published: 08/07/2020

Article revision time: 14 days

Article Online First time: 89 days

Article editing time: 103 days


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