studies

770A AASLD ABSTRACTS HEPATOLOGY, October, 2015
SVR12 Rates by Major Risk Factors
Demographics(%)
Disclosures:
T. Craig Cheetham - Grant/Research Support: Gilead, BMS
The following authors have nothing to disclose: Sara Y. Tartof, Zoe Bider-Canfield,
Vincent Louie, Derenik Gharibian, Amandeep K. Sahota
1136
Evaluation of an Integrated HIV/HCV Care Model in an
Urban, Low-Income, HIV/HCV Co-Infection Clinic
Angela Kapalko 1 , Linden Lalley-Chareczko 1 , Meghan F. Fibbi 2,3 ,
Karam Mounzer 1,4 ; 1 Jonathan Lax Treatment Center, Philadelphia
FIGHT, Philadelphia, PA; 2 Department of Family and Community
Medicine, University of Pennsylvania, Philadelphia, PA; 3 Philadelphia
College of Osteopathic Medicine, Philadelphia, PA; 4 Perelman
School of Medicine, University of Pennsylvania, Philadelphia,
PA
Background The Jonathan Lax Treatment Center is an urban,
low-income, Ryan White and FQHC funded, outpatient medical
center providing services via an integrated care model to
approximately1700 patients with HIV, of whom 459 are HIV/
Hepatitis C(HCV) co-infected. The HIV/HCV co-infection treatment
protocol at the Lax Center incorporates on-site disease
staging, pharmacy refills/pill-packing services with flexible
dispensation schedules, adherence monitoring, case management
and mental health services.The purpose of the present
observational study is to evaluate the comprehensive HIV/HCV
co-infection treatment protocol in a patient-centered care setting
at the Lax Center. Methodology A comprehensive chart review
of all Lax Center patients carrying a diagnosis of chronic
HCV between the calendar years of 2011 and 2014(n=459)
was performed. Patient demographics, HCV genotyping and
disease staging, prior HCV treatment experience, HCV sustained
virologic response(SVR) and information on comorbid
conditions present during HCV treatment were recorded. All
co-infected patients were included in the overall demographic
analysis; however, patients treated on a clinical trial were
excluded from the treatment outcome analyses. Results 459
co-infected patient records active between Jan 1, 2011 and
Dec 31 2014 were reviewed. 88 individual patients(19.1%,
n=459) received treatment during this time frame, 10 of whom
were retreated, making the total number of treatments delivered
98. 26 treatments were excluded due to participation in
clinical trials, leaving 72 eligible treatments for final analyses.
The demographics of those treated were similar to the overall
Lax HIV/HCV population (See Table 1). 31.9% of all treatment
efforts consisted of Telaprevir based regimens with an
SVR12 rate 56.5%(n=23). IFN free regimens (SOF/RBV, SOF/
SMV, SOF/LDV)(n=43) yielded an SVR12(n=39) of 87.1%
with 4 SVR12 results pending(2 confirmed SVR4). No patients
were lost-to-follow-up while on treatment or during post-treatment
monitoring. Conclusions Operating under a patient-centered,
integrated care model, the Lax Center was able to treat
19.1%(n=88) of active HIV/HCV patients, retain 100% in
care, and achieved an overall SVR rate of 75.0%(with 4 SVR
12 pending). These data support the utility of an integrated
care model for optimization of treatment outcome among HIV/
HCV co-infected patients in an urban, low-income community
setting.
Disclosures:
Angela Kapalko - Advisory Committees or Review Panels: Gilead Sciences, Abbvie;
Speaking and Teaching: Abbvie
Karam Mounzer - Advisory Committees or Review Panels: Gilead Sciences, BMS,
J& J, Merck; Grant/Research Support: Boehrlingher Ingelheim, Gilead Sciences,
Glaxo Smith Kline ViiV, Janssen and Janssen, Merck; Speaking and Teaching:
Gilead Sciences, BMS, J& J, Merck
The following authors have nothing to disclose: Linden Lalley-Chareczko, Meghan
F. Fibbi
1137
What does Fibroscan® measure shortly after IFN-free
DAA therapy?
Karin Kozbial, Albert Stättermayer, Clarissa Freissmuth, Rafael
Stern, Sandra Beinhardt, Christian Rechling, Petra E. Steindl-
Munda, Michael Trauner, Peter Ferenci, Harald Hofer; Internal
Medicine 3, Medical University of Vienna, Vienna, Austria
Background:Sustained virological response (SVR) by any antiviral
therapy may improve liver fibrosis in the majority of patients
during long-term follow up. Interferon free combinations of
direct acting antivirals (DAAs) achieve a rapid and profound
inhibition of HCV replication during treatment and offer the
possibility to study short-term changes in fibrosis.Therefore
this study investigated liver stiffness in patients with advanced
fibrosis (F3-F4) shortly after DAA treatment. Methods:Liver stiffness
was measured before and at the end or up to 12 weeks
after the end of DAA-therapy (Sofosbuvir[SOF] combined with
daclatasvir[DCV, n=52], ribavirin [n=10], ledipasvir [n=14],
Simeprevir [SMV, n=24], or the combination of DCV and SMV
[n=9])by Fibroscan®(FS; Echosens 502, Paris, France) in 109
patients (f/m=40/69; mean age: 55.2±10.5yrs; genotype
(GT) 1: 87, GT3: 16, GT4: 6; F3/F4=28/81; BMI 27.1±4.4).
Treatment duration was 12 (n=48) up to 24 weeks (n=61).
Only FS results with IQR ≤ 30% were included. Liver fibrosis categories
were defined as advanced fibrosis (F3:9.6-12.4kPa),
and cirrhosis (F4: ≥12.5kPa). Results:Overall, liver stiffness
decreased from 23.2kPa (95% CI 20.4-26.0) to 20.1kPa (95%
CI 17.0-23.3;p