studies

962A AASLD ABSTRACTS HEPATOLOGY, October, 2015
intrahepatic virological and inflammatory parameters (Median
of HBV tDNA: 7.90 vs. 7.45Log 10
copies/10 6 cells, P = 0.593;
Median of cccDNA: 6.1 vs. 5.0Log 10
copies/10 6 cells, P =
0.052; Percentage of inflammation ≥ G2: 77.8% (21/27)
vs. 84.6% (11/13), P = 0.933). Furthermore, comparable
levels of intrahepatic HBV tDNA (Median: 7.89 vs. 7.90Log-
10 copies/106 cells, P = 0.395) and significantly lower cccDNA
(Median: 4.75 vs. 6.82Log 10
copies/10 6 cells, P = 0.003) were
presented in the patients with undetectable serum HBV DNA
and normal ALT compared to the patients wits undetectable
serum HBV DNA and abnormal ALT, and 61.5% (8/13) of the
patients with undetectable serum HBV DNA and normal ALT
were found intrahepatic inflammation ≥ G2. Conclusion: More
than 60% HBV-related compensated cirrhosis patients with
serum HBV DNA undetectable or at low levels and normal ALT
had active intrahepatic inflammation and HBV replication, thus
the administration of antiviral therapy might be strengthened.
Disclosures:
The following authors have nothing to disclose: Taotao Yan, Xiaoying Sha, Jing
Wang, Li Jin, Yu Zhang, Ruitian Yi, Furong Cao, Yuan Yang, Jinfeng Liu, Yingli
He, Tianyan Chen, Yingren Zhao
1542
Comparing antiviral efficacy of Tenofovir monotherapy
and Tenofovir based combination therapy in antiviral
resistant chronic hepatitis B: A interim result of multicenter
cohort study
Kyu sik Chung 1 , Beom Kyung Kim 1 , Ki Tae Yoon 2 , Hana Park 3 ,
Chang Wook Kim 4 , Jin-Woo Lee 5 , Young Seok Kim 6 , Jung Il Lee 7 ,
Jun Yong Park 1 , Seung Up Kim 1 , Do Young Kim 1 , Sang Gyune
Kim 6 , Young-Joo Jin 5 , Hee Yeon Kim 4 , Seong Gyu Hwang 3 , Mong
Cho 2 , Kwan Sik Lee 7 , Kwang-Hyub Han 1 , Sang Hoon Ahn 1 ;
1 Department of Internal Medicine, Yonsei University College of
Medicine, Seoul, Korea (the Republic of); 2 Department of Internal
Medicine, Pusan National University School of Medicine, Yangsan,
Korea (the Republic of); 3 Department of Internal Medicine,
CHA Bundang Medical Center, Bundang, Korea (the Republic of);
4 Department of Internal Medicine, The Catholic University of Korea
College of Medicine, Seoul, Korea (the Republic of); 5 Department
of Internal Medicine, Inha University College of Medicine, Incheon,
Korea (the Republic of); 6 Department of Internal Medicine, Soonchunhyang
University College of Medicine, Cheonan, Korea (the
Republic of); 7 Department of Internal Medicine, Gangnam Severance
Hospital, Seoul, Korea (the Republic of)
Background: We aimed to compare antiviral efficacy between
tenofovir (TDF) monotherapy and TDF-based combination therapy
as a rescue therapy for chronic hepatitis B with resistance
to antiviral agents. Methods: A total of 847 consecutive CHB
patients treated with TDF monotherapy or TDF-based combination
therapy (TDF plus entecavir, lamivudine or telbivudine)
as a rescue therapy for resistance to antiviral agents were
analyzed. Complete virological response (CVR) and biochemical
response were defined as undetectable serum HBV-DNA
(detection limit 20 IU/mL) and normalization of serum alanine
aminotransferase (ALT) level, respectively. Results: At the time
of rescue therapy, the median serum HBV DNA and ALT level
were 3.36 log IU/mL and 28 IU/mL, respectively. During the
follow-up (median 18.3 month), cumulative rates of CVR at
24 months among patients with resistance to lamivudine only
(n=474) were similar between those with TDF monotherapy
and those with TDF-based combination therapy (95.6% vs.
92.4%, respectively). Similar results (95.5% vs. 94.0%, respectively)
were maintained in patients with multidrug-resistance
(n=373) (resistance to lamivudine and entecavir [n=189], resistance
to lamivudine and adefovir [n=137], and resistance to
lamivudine, adefovir, and entecavir [n=47]) (all p>0.05). In
HBeAg- positive patients, cumulative HBeAg seroconversion
rate at 24 months was comparable between those with TDF
monotherapy and those with TDF-based combination therapy
(7.6% vs. 11.8%, P=0.258). Conclusions: TDF monotherapy
showed similar antiviral efficacy compared with TDF-based
combination therapy as a rescue therapy, even in patients with
multi-drug resistance. Further studies with a longer follow-up
are required to validate these results
Disclosures:
Ki Tae Yoon - Grant/Research Support: Handok; Speaking and Teaching: Gilead,
BMS, MSD, Roche, GSK
Chang Wook Kim - Consulting: Gilead Korea, MSD; Grant/Research Support:
BMS Korea, Daewoong, Handok, Pharmicell, Pharmaking, Gilead Korea; Speaking
and Teaching: BMS Korea, Daewoong
The following authors have nothing to disclose: Kyu sik Chung, Beom Kyung Kim,
Hana Park, Jin-Woo Lee, Young Seok Kim, Jung Il Lee, Jun Yong Park, Seung Up
Kim, Do Young Kim, Sang Gyune Kim, Young-Joo Jin, Hee Yeon Kim, Seong Gyu
Hwang, Mong Cho, Kwan Sik Lee, Kwang-Hyub Han, Sang Hoon Ahn
1543
Hepatitis B virus infection in irregular and refugee
migrants in Naples, Italy
Nicola Coppola 1 , Loredana Alessio 1 , Luciano Gualdieri 2 , Mariantonietta
Pisaturo 3 , Caterina Sagnelli 4 , Nunzio Caprio 5 , Carmine
Minichini 1 , Mario Starace 1 , Giuseppe Signoriello 1 , Giuseppe
Pasquale 1 , Evangelista Sagnelli 1 ; 1 Mental Health and Public Medicine,
Second University of Naples, Naples, Italy; 2 Medical Center,
Centro per la Tutela della Salute degli Immigrati, Naples, Italy;
3 Medical Center, Centro di Accoglienza “La tenda di Abramo”,
Caserta, Italy; 4 Medical Center, Centro Sociale ex Canapificio,
Caserta, Italy; 5 Medical center, Centro Suore Missionarie della
Carità, Naples, Italy
Aim: to define the characteristic of HBV infection in a cohort of
irregular or refugee immigrants living in Italy, a country with an
HBsAg prevalence nearly 1% and a HBV universal vaccination
covering subjects under 35. Methods: A screening for HBV,
HCV and HIV infections was offered free of charge and of
bureaucratic procedures to 1,254 illegal or refugee immigrants
living from 5 years or more in Naples or in its surroundings
(Italy). Of these 1,254, 1,212 (96.6%), 831 irregular and
381 refugees, accepted to be screened at one of 4 first-level
clinical centers operating for years in this setting, with proven
experience in clinical, psychological and legal management
of vulnerable groups. The median age of screened subjects
was 32 years, range 12-74, 75.2% were males, 52% came
from Sub-Saharan Africa, 18% from Eastern-Europe, 13% from
Indo-Pakistan Area, 7% from Northern-Africa and the remaining
10% from others countries. Positive subjects ware further
investigated at two third-level liver units. Results: One-hundred
sixteen migrants (9.6%) were HBsAg positive, 490 (40.4%)
HBsAg negative/anti-HBc positive and 606 (50%) sero-negative
for both. All positive subjects ignored their serological
status. A high HBsAg sero-prevalence was found in migrants
from sub-saharan Africa (13.8%) and an intermediate one in
those from Eastern Europe (6%), Northern Africa (3.4%) and
Indo-Pakistan area (2.8%). A logistic regression analysis identified
as factors independently associated with HBV infection
(both HBsAg positive and HBsAg negative/anti-HBc positive)
the male gender (p=0.002), the sub-Saharan African origin
(p