studies

494A AASLD ABSTRACTS HEPATOLOGY, October, 2015
The following authors have nothing to disclose: Luca Fabris, Stefano Okolicsanyi,
Matteo Rota, Paolo Cortesi, Luca S Belli, Stefano Fagiuoli, Luciana Scalone,
Giancarlo Cesana, Mario Strazzabosco
572
Knowledge about hepatitis B transmission risks among
health professionals in Tanzania
Jose Debes 1 , Johnstone Kayandabila 2 , Hope Pogemiller 1 ; 1 University
of MInnesota, Minneapolis, MN; 2 Arusha Lutheran Medical
Centre, Arusha, United Republic of Tanzania
Introduction: It is well known that hospital workers are at
increased risk for contracting hepatitis B virus (HBV). This risk
it is increased in settings of high HBV seroprevalence, such as
sub-Saharan Africa. Despite this, it is unclear whether healthcare
providers in developing countries are aware of the transmission
risks and adhere to universal precaution strategies.
In this study we aimed to evaluate the knowledge and understanding
of HBV among health-care workers in hospitals in
Tanzania. Methods: We provided a HBV survey to staff in 2
hospitals in northern Tanzania. The survey consisted of nine
multiple-choice questions that inquired about understanding
of HBV serostatus, vaccination and risks of transmission of
HBV. The survey was written in English and Swahili (the local
language) and distributed among medical and non-medical
staff (laboratory technicians, students, etc). Multivariate analyses
were performed using Fishers exact test and Chi-square.
Results: We received voluntary participation from 114 subjects
in our survey. The mean age of the participants was 33
y/o, 67% were females, and 61% responded to the survey in
English. Ninety one percent of subjects had no knowledge of
their HBV surface antigen status, and 89% indicated they never
received a vaccine for HBV, with lack of knowledge about
the vaccine being the most common reason (34%). Seventy
percent of participants new about HBV complications and 60%
responded correctly inquires about transmission routes. There
was a significant difference in knowledge of HBV serostatus
and vaccination between participants with a medical background
(consultants, interns, etc) and others, p=0.01 and
p-0.001 respectively. However, only 33% of consultants knew
about their HBV serostatus or were vaccinated for it. There
was no significant difference between knowing HBV transmission
route or in-hospital risk and whether the survey was
answered in English or local language, or hospital position of
the responder. Conclusions: Our study shows a surprisingly low
knowledge of HBV serostauts and vaccination status among
hospital workers in Tanzania. Studies are needed in other parts
of sub-Saharan Africa to further understand this gap in knowledge,
and HBV awareness programs should be promoted.
Disclosures:
The following authors have nothing to disclose: Jose Debes, Johnstone Kayandabila,
Hope Pogemiller
573
Hepatitis C Virus Sustained Virologic Response Rates
among Patients Treated in Primary Care Settings in New
York State
Colleen Flanigan, Jason Pendergast; New York State Department
of Health, Albany, NY
Background Hepatitis C virus (HCV) treatment has been rapidly
changing over the last few years. With the arrival of direct
acting anti-viral therapies, HCV treatment is now highly effective.
As a result of these more effective treatments, the demand
for HCV treatment is increasing, adding strain to an already
limited number of specialists available to treat HCV. The newer
treatments are less complex, more tolerable and treatment
durations can be as short as eight weeks, thus, allowing for
primary care providers (PCPs) to treat HCV. To expand access
to HCV care and treatment in New York State (NYS), the NYS
Department of Health provides funding to 13 primary care sites
to integrate HCV care and treatment. These primary care sites
include: community health centers, hospital-based clinics, a
methadone maintenance treatment program and a residential
drug treatment program. At each of these settings, a PCP and
a multidisciplinary team manages and treats persons infected
with HCV. Each PCP is an experienced HCV provider with the
knowledge and skills to safely and effectively manage and
treat HCV. Each PCP has an agreement with a liver specialist
for consultation. The purpose of this study was to evaluate
HCV treatment sustained virologic response (SVR) rates
among patients receiving HCV treatment in a primary care
setting. Methods This analysis looks at HCV SVR rates among
HCV monoinfected and HIV/HCV coinfected patients enrolled
at 13 primary care sites across NYS. All primary care sites
report client level data using the AIDS Institute Reporting System
(AIRS). AIRS is a comprehensive client and service/encounter
reporting application. AIRS also collects HCV treatment type
and treatment outcome (SVR). Results From October 1, 2010
through April 30, 2015, 2,447 HCV infected patients were
served by the 13 primary care sites. Of these patients, 816
(33.3%) initiated HCV treatment and of these patients 743
(91.1%) had final treatment outcomes available for analysis.
The overall SVR rate among these patients was 61.5%; 70.1%
among HCV monoinfected and 50.8% among HIV/HCV coinfected
patients. SVR rates ranged from 49.3% among those
treated with the combination pegylated interferon and ribavirin
to as high as 96.6% among those treated with ledipasvir-sofosbuvir.
Conclusions These findings illustrate that HCV treatment
SVR rates are just as good in primary care settings as they are
in specialty settings. Therefore, integrating HCV treatment into
primary care can help increase capacity for HCV treatment
and allow more people to be cured of HCV.
Disclosures:
The following authors have nothing to disclose: Colleen Flanigan, Jason Pendergast
574
External Validity of Trials in Non-Alcoholic Fatty Liver
Disease: Systematic Review of Randomised Controlled
Trials and Non-Randomised studies
Richard Parker 1 , James Hodson 2 , Ian A. Rowe 1 ; 1 Centre for Liver
Research, University of Birmingham, Birmingham, United Kingdom;
2 University Hospitals Birmingham NHS Foundation Trust, Birmingham,
United Kingdom
Introduction Trials with good external validity allow clinicians
and patients to have confidence in new treatments. Individuals
in clinical trials are often highly selected, in part to remove
confounding factors, but this can introduce bias and limit the
external validity of a trial. In this study, we surveyed observational
studies and randomised controlled trials (RCT) to gauge
the external validity of trials in non-alcoholic fatty liver disease
(NAFLD). Methods Structured literature searches were undertaken
for observational studies (ObS) and RCT in NAFLD. Data
were extracted from included studies. Participant characteristics
were compared between observational studies and RCT, and
between subsets of observational studies describing with biopsy-proven
non-alcoholic steatohepatitis (NASH) or advanced
fibrosis (>F2). For age and BMI, weighted means were calculated
and compared with t-tests, for prevalence of Diabetes mellitus
(DM) and gender, Chi-squared was used for comparisons.