studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 719A
respondents ascertained prior awareness of HCV infection status.
Population percentages and p-values were weighted to
adjust for sampling design. Results: 162 of 458 NHANES
respondents who tested positive for HCV antibodies or RNA
during 2003-2012 participated in the follow-up survey. Of
these, 91 (59%) reported that they were already aware of
their HCV status when informed of their positive HCV test in
NHANES. Rates of prior HCV status awareness varied considerably;
71% of adults born in 1945-1965 reported prior
awareness, for example, compared to 28% of adults not in
major risk groups (p=0.096). People living above 2x Federal
poverty level (FPL) were more likely (72%) than those below 2x
FPL (48%) to have been aware of their HCV status (p=0.019).
Conclusions: HCV screening practices before 2010 appear to
have identified just over half of total HCV cases in the non-institutionalized
US population. Furthermore, large disparities exist
in awareness of HCV status, particularly among marginalized
and seemingly low-risk groups. With new therapies promising
higher certainty of cure for people with HCV, development of
effective screening policies is of great importance.
Disclosures:
Mark T. Linthicum - Employment: Precision Health Economics
Timothy R. Juday - Employment: AbbVie; Stock Shareholder: AbbVie
Gigi Moreno - Consulting: AbbVie
Yuri Sanchez - Employment: AbbVie; Stock Shareholder: AbbVie
Darius Lakdawalla - Consulting: AbbVie Pharmaceuticals; Stock Shareholder:
Precision Health Economics
Steven Marx - Employment: AbbVie; Stock Shareholder: AbbVie
The following authors have nothing to disclose: Brian R. Edlin
1043
Sustained Virologic Response to Direct Acting Antiviral
Therapy for Chronic Hepatitis C Infection is Associated
with Improvement of Components of the Metabolic Syndrome
Mark Pedersen 1 , David W. Backstedt 2 , Bobby Kakati 2 , Myunghan
Choi 3 , Anil B. Seetharam 4,5 ; 1 Department of Internal Medicine,
Banner University Medical Center, Tempe, AZ; 2 Department of
Gastroenterology, Banner University Medical Center, Phoenix, AZ;
3 Arizona State University College of Nursing and Health Care
Innovation, Tempe, AZ; 4 Banner Transplant and Advanced Liver
Disease, Phoenix, AZ; 5 University of Arizona College of Medicine
Phoenix, Phoenix, AZ
Rationale: Chronic hepatitis C virus (HCV) infection has been
linked to the metabolic syndrome. While direct acting antiviral
(DAA) therapy for HCV is often successful in achieving
sustained virologic response (SVR), pleiotropic effects on
components of the metabolic syndrome have not been fully
characterized. Aim: To evaluate the effect of DAA HCV therapy
on components of the metabolic syndrome. Methods: A
prospective, cohort study of consecutively enrolled, mono-infected
chronic HCV patients initiated on treatment with a DAA
regimen. Consecutively enrolled patients received one of the
following: 1) pegylated interferon alfa 2a (IFN) + sofosbuvir
(SOF) + ribavirin (RBV); 2) SOF + RBV; 3) SOF + simeprevir
(SMV) or 4) ledipasvir (LDV) + SOF in accordance with AASLD
guidelines. Metabolic parameters including: body mass index
(BMI), systolic blood pressure (BP), diastolic BP, fasting glucose,
total cholesterol, high density lipoprotein (HDL), low density
lipoprotein (LDL), triglycerides, and fasting glucose were measured
prior to and at the end of treatment. Subgroup analysis
evaluated metabolic profile changes between groups achieving
SVR at 12 weeks. Changes in metabolic parameters were
analyzed with student’s t test, p < 0.05 significant. Results:
Patients (n=218) completed treatment with a DAA based regimen:
IFN + SOF + RBV (17%); SOF + RBV (54.6%); SMV +
SOF (23.4%) and SOF + LDV (6%). Of 218 enrolled, 61.5%
genotype 1 and 56.4% cirrhotic. Previous IFN exposure: 64%
naïve followed by non-response (26%) and relapse (10%). The
highest prevalence of concomitant metabolic syndrome parameter
prior to treatment was hypertension (38.5%) followed by
diabetes (16.5%) and hyperlipidemia (15.3%). For the entire
cohort, end of treatment (ETR) was 98%, with 79% going on
to achieve SVR 12 (19% relapsers). At ETR, significant reductions
in BMI, systolic and diastolic BP, total cholesterol, and
LDL were noted in the entire cohort (all p