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. 2022 Dec 23;12(12):e062680.
doi: 10.1136/bmjopen-2022-062680.

LINK-B: study protocol of a retrospective and prospective project for identification and linkage to care of people living with hepatitis B in a large health area of Barcelona

Ana Barreira Díaz  1   2   3 , Ariadna Rando  4 , Anna Feliu-Prius  1   2 , Adriana Palom  1 , Francisco Rodríguez-Frías  3   4 , Elena Vargas-Accarino  1   2 , Judit Vico-Romero  1 , Nieves Palomo  1 , Mar Riveiro-Barciela  1   2   3 , Rafael Esteban  1   3 , Maria Buti  5   2   3
Affiliations

LINK-B: study protocol of a retrospective and prospective project for identification and linkage to care of people living with hepatitis B in a large health area of Barcelona

Ana Barreira Díaz et al. BMJ Open. .

Abstract

Introduction: An estimated 290 million people are living with hepatitis B virus (HBV) worldwide; in Spain, the prevalence of hepatitis B virus surface antigen (HBsAg) is 0.4%. In our setting, many HBsAg-positive individuals are not linked to care, which implies a barrier to receiving treatment and controlling the infection. The main objective of this project is to evaluate the performance of a programme designed to achieve appropriate linkage to specialist care of HBsAg-positive individuals, newly tested or previously tested and lost to follow-up.

Methods and analysis: This is a retrospective and prospective study in which all HBsAg-positive cases recorded in the microbiology database will be identified. The retrospective phase will include cases detected between 2018 and 2020, and the prospective phase will run from January 2021 to June 2022. The project will be carried out in a tertiary university hospital covering the northern health area of Barcelona with a catchment population of 450 000 inhabitants and 16 affiliated primary care centres. The central laboratory detects approximately 1200 HBsAg-positive individuals every year; therefore, we expect to identify around 4000 patients over the duration of the project. The medical records of HBsAg-positive individuals will be consulted to identify and retrieve those who have not been appropriately linked to care. Candidates will be contacted to offer specialist disease assessment and follow-up. A website will be created to provide HBV-related information to primary care physicians, and a mobile phone application will be available to patients to improve the linkage circuits and ensure follow-up continuity.

Ethics and dissemination: The Vall d'Hebrón Hospital Ethics Committee (PR(AG)201/2021) and the Spanish Agency of Medicines and Medical Devices approved this study. The findings will be disseminated through peer-reviewed publications and conference presentations. This programme could increase the number of HBsAg-positive individuals properly linked to care and achieve better HBV monitoring, which will have a positive impact on WHO's viral hepatitis elimination goals.

Keywords: Hepatology; Telemedicine; VIROLOGY.

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Conflict of interest statement

Competing interests: MB has served as a speaker and advisory board member for Gilead, Roche and Arbutus. MR-B has served as a speaker for AbbVie and Gilead. RE has served as a speaker and advisory board member for Gilead, Roche and Arbutus.

Figures

Figure 1
Figure 1
Information technology tools developed as part of the project and the main uses. HBV, hepatitis B virus.
Figure 2
Figure 2
Phone application (app) features shared with patients. PROMs, Patient Reported Outcomes Measures.
See this image and copyright information in PMC

References

    1. , European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver . EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol 2017;67:370–98. 10.1016/j.jhep.2017.03.021 - DOI - PubMed
    1. McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology 2021;73 Suppl 1:4–13. 10.1002/hep.31288 - DOI - PMC - PubMed
    1. World Health Organisation . Global progress report on HIV, viral hepatitis and sexually transmitted infections. 53. WHO, 2021.
    1. Epidemiología CNde, Carlos IdeS. Vigilancia Epidemiológica de la hepatitis B en España, 2020.
    1. McMahon BJ. Chronic hepatitis B virus infection. Med Clin North Am 2014;98:39–54. 10.1016/j.mcna.2013.08.004 - DOI - PubMed

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