studies

976A AASLD ABSTRACTS HEPATOLOGY, October, 2015
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Health care disparity in delivering optimal care to
chronic hepatitis B pregnant mothers
Rasham Mittal, Amandeep K. Sahota; Kaiser Permanente Los
Angeles Medical Center, Los Angeles, CA
Background Roughly 24,000 chronic hepatitis B (CHB) pregnant
women give birth in United States every year. Since perinatal
acquisition of CHB contributes significantly to prevalence
of CHB, it becomes imperative to provide optimal antenatal
care to these mothers. Study Aim: - Determine if health care
disparities exist in antenatal care of CHB pregnant mothers at
a large integrated health care system in United States. Methods:
Retrospective study (January 2005- June 2010) at a large
integrated health care system in Southern California. All CHB
pregnant mothers identified using the regional perinatal database.
Inclusion criteria: age > 18 years and positive serum
HBsAg (hepatitis B surface antigen). They were excluded if
tested negative for HBsAg; tested positive for preliminary
enzyme-linked immunosorbent assay (ELISA) HBsAg but had
non-reactive HBsAg neutralization confirmatory antibody assay
(false positive); termination of pregnancy or lost to follow up.
Only first live-birth pregnancy was considered for CHB mothers
who delivered more than once during the study timeline. Chart
review was performed to determine maternal antenatal hepatitis
Be antigen (HBeAg) serology, antenatal hepatitis B virus (HBV)
viral load and specialist consultation visits. Results: A total of
462 CHB pregnant mothers were identified. The mean maternal
age in years was 32.5 ± 4.8 (range 18-45, median 33).
Highest prevalence of CHB was noted in Asian Pacific Islander
mothers (78.8%), followed by non-Hispanic white (9.7%), Hispanic
white (5.8%), non-Hispanic black (5.2%) and Hispanic
black (0.4%). Antenatal hepatitis Be antigen (HBeAg) serology
testing was performed in 274 (59.3%) and hepatitis B virus
(HBV) viral load was tested in 156 (33.8%) mother only. Only
93 (20.1%) mothers had a specialist consultation during their
pregnancy. Among these 93 mothers, 90 consulted gastroenterologist
and 3 hepatologist. Additionally 104 (26.2%) infants
born to these CHB mothers had no HBsAg serological testing
at 9-18 months follow up. Conclusion: - Significant health care
disparities in standard care of CHB pregnant mothers identified
at a large integrated health care system in United States.
Disclosures:
The following authors have nothing to disclose: Rasham Mittal, Amandeep K.
Sahota
1570
Ultrasound predicts steatosis in patients with chronic
hepatitis B
Erin Kelly 2,1 , Vickie A. Feldstein 3 , Rebecca Hudock 1 , Marion G.
Peters 1 ; 1 Hepatology, University of California San Francisco, San
Francisco, CA; 2 Gastroenterology and Hepatology, University of
Ottawa, Ottawa, ON, Canada; 3 Radiology, UCSF, San Francisco,
CA
Inflammation and fibrosis may impair the ability of ultrasound
to identify steatosis in patients with chronic hepatitis B (CHB).
We determined the accuracy of ultrasound (US) in grading
steatosis in patients with CHB compared to liver biopsy, and
examined clinical factors associated with steatosis. This was a
single-center, retrospective study of all non-transplanted CHB
patients undergoing US and same day liver biopsies from
2004-2014. Steatosis was graded by US as none, mild, moderate
or severe. Liver histology graded steatosis (0: