studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1083A
1795
Distribution of pre-existing NS5A/NS5B resistance associated
variants in genotype 1b patients with hepatitis C
virus and response to direct acting antivirals
Takeshi Watabe, Masaaki Korenaga, Masaya Sugiyama, Erina
Kumagai, Misuzu Ueyama, Yoshihiko Aoki, Yoko Yamagiwa,
Keiko Korenaga, Masatoshi Imamura, Kazumoto Murata, Naohiko
Masaki, Tatsuya Kanto, Masashi Mizokami; The research center
for hepatitis and Immunology, National Center of Global Health
and Medicine (NCGM) at Kohnodai, Ichikawa, Japan
Background and Aim: Although interferon-free antiviral treatment
is improved sustained virological response (SVR) rate of
hepatitis C virus (HCV), pre-existing NS5A/NS5B resistance
associated variants (RAVs) may affect the efficiency of some
HCV regimens. The aim of study is to investigate whether the
NS5A/NS5B RAVs interact with clinical characteristics and
response to 12 weeks of treatment with the nucleotide polymerase
inhibitor sofosbuvir (SOF) combined with the NS5A
inhibitor ledipasvir (LDV) for genotype (GT)-1b infection. Methods:
Three hundred sixteen Japanese patients with HCV GT-1b
(mean Age [ys]:67, male [%]:32, treatment naïve [%]:53 cirrhosis
[%]:30, and hepatocellular carcinoma (HCC) [%]:10)
were examined NS5A/NS5B RAVs by direct sequence. NS5A
RAVs included L31M/I/V/F and Y93H, and NS5B RAVs
included S282T and C316N. The frequency of the RAVs was
examined the association with clinical characteristics, such as
age, sex, naïve/experienced, HCVRNA, fibrosis, and hepatocellular
carcinoma (HCC). Fibrosis was evaluated by Fibroscan
and Mac-2 binding protein glycogen isomer. Among
these patients, 59 patients (23%) who received LDV (90 mg)/
SOF (400 mg) for 12 weeks were analyzed the association
of pre-treatment NS5A/NS5B RAVs with treatment outcome.
Results: Distribution of NS5A RAVs existed 5% for L31 and
23% for Y93. Double mutations in NS5A were detected only
5 patients (1.5%). Distribution of NS5B RAVs existed 48% for
C316; however there were no detection for S282 mutation. No
association of these RAVs distribution with clinical characteristics.
Fifty nine patients with receiving SOF/LDV were detected
23% for NS5A RAVs, 48% for C316N, and 11% for NS5A
RAVs with C316N and All 59 patients achieved SVR (100%).
Conclusions: Although pre-treatment NS5A and NS5B RAVs in
Japanese patients with infected HCV GT-1b exist about 25%
and 50% respectively, presence of single RAVs, and NS5A
RAVs with C316N in NS5B are less association with clinical
characteristics, and treatment outcome of SOF/LDV.
# All 59 patinets trerated with SOF/LDV for 12 weeks and
achieved SVR
Disclosures:
The following authors have nothing to disclose: Takeshi Watabe, Masaaki
Korenaga, Masaya Sugiyama, Erina Kumagai, Misuzu Ueyama, Yoshihiko Aoki,
Yoko Yamagiwa, Keiko Korenaga, Masatoshi Imamura, Kazumoto Murata, Naohiko
Masaki, Tatsuya Kanto, Masashi Mizokami
1796
Prevalence of viral hepatitis and liver fibrosis in streetbased
outreach: a French prospective multicentre study
Juliette Foucher 13 , Jean Harbonnier 1 , Leon Gomberoff 2 , Sylvie
Balteau 3 , Fadi Meroueh 4 , Beatrice Stambul 5 , Rolland Le Hello 6 ,
Brigitte Reiller 7 , Xavier Richen 8 , Elisabeth Avril 9 , Jean-Pierre
Daulouede 10 , Anne Borgne 11 , Veronique Latour 12 , Jean-Baptiste
Hiriart 13 , Victor de Ledinghen 13 ; 1 CSAPA Boris Vian, Lille, France;
2 CSAPA Ego Aurore, Paris, France; 3 CSAPA Les Wads, Metz,
France; 4 CSAPA Arc en Ciel, Montpellier, France; 5 CSAPA Villa
Floreal, Aix en Provence, France; 6 CSAPA L’envol, Rennes, France;
7 CEID CSAPA Planterose, Bordeaux, France; 8 CSAPA du griffon
Aria, Lyon, France; 9 CSAPA Gaia, Paris, France; 10 CSAPA Bizia
Medecin du Monde, Bayonne, France; 11 service d’addictologie
Hopital Muret, Sevran, France; 12 CSAPA La case Medecins du
monde, Bordeaux, France; 13 hepatology unit, Bordeaux, France
Introduction French Association for the Study of the Liver diseases
guidelines recommends treatment of drug users whatever
liver fibrosis stage. The aim of this prospective multicentre
study was to evaluate viral hepatitis in French street-based outreaches
and their severity. Patients and methods From January
2012 to March 2013, all consecutive subjects with intravenous
drug use (PWID) without any HCV management and consulting
in street-based outreach in France were included. After face-toface
questionnaire by outreach worker, liver stiffness was measured
by FibroScan (FS). At the end of FS, a blood sample for
hepatitis B and C serology was proposed as a meeting with a
practitioner. During face-to-face interview, socio-demographic
parameters and way of living were recorded. During the medical
meeting, the result of serology and FS were explained. If
case of HCV infection, users could meet a hepatologist and
treatment could be proposed. Results In 12 French street-based
outreaches, 860 drug-users were included (663 men, mean
age 37 years, BMI 23 kg/m 2 , injected drug used history
n=447, currently opioid substitution 62%, homeless 16,%,
unemployed 72%, past history of incarceration 43%). 813
subject accepted FS, with correct measurement in 94.5% of
cases. Median liver stiffness was 5.1 kPa (2-75 kPa). 16.4% of
users had significant fibrosis (FS>7.6 kPa) and 4.8% cirrhosis
(FS>13 kPa). 77% of drug users with interpretable FS had a
blood sample. HCV prevalence was 34%. HIV and HBV prevalence
were 2% and 1.2%, respectively. Factors associated with
HCV infection were age, history of IVDU, history of incarceration
and no insurance. In multivariate analysis, factors associated
with HCV were history of IVUD (OR 19.38, [9.9-37.8]
p