studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1105A
not been identified. Wisteria floribunda agglutinin–positive
human Mac-2 binding protein (WFA(+)-M2BP) was reported
to be a novel serum marker of liver fibrosis identified in glycoproteomic
biomarker screening studies, and was effective for
evaluating advanced liver fibrosis. However, its usefulness in
less-advanced liver fibrosis has not been fully elucidated. In this
study, we examined the utility of WFA(+)-M2BP as liver fibrosis
marker in patients with less-advanced liver fibrosis. Methods:
One hundred forty-three patients with biopsy-proven chronic
hepatitis C were enrolled in this study. We examined the association
between WFA(+)-M2BP and the results of blood biochemistry
and liver histology examinations. Results: Fifty-nine
patients were male, and the mean age of the entire group
was 60 years. The mean platelet count was 16.6×10 4 /mL,
serum ALT was 48 IU/L, AFP was 4.9 ng/dL, and liver fibrosis
scores of F0–1/F2/F3/F4, respectively, were 80/42/14/7.
WFA(+)-M2BP rose with liver fibrosis progression, was significantly
correlated with liver fibrosis markers and scores, and
was significantly associated with histopathology findings of
liver fibrosis. For cases of less-advanced liver fibrosis (stage
F2 or less), WFA(+)-M2BP was significantly elevated by a
liver fibrosis extension case. Receiver operating characteristic
(ROC) analysis revealed that the WFA(+)-M2BP cut-off value of
1.94 [C.O.I.] discriminated between stages F2 and F0–1 (area
under the ROC curve, 0.768) better than other serum markers
such as platelet count (0.613), hyaluronic acid (0.661), type
IV collagen (0.627), and procollagen III peptide (0.610), and
better than liver fibrosis scores such as the FIB4 index (0.645)
and APRI (0.660). In the multivariate analysis, high WFA(+)-
M2BP was an independent factor associated with mild liver
fibrosis (F2) (OR, 6.37; 95% CI, 1.85–22.00; P=0.003). Furthermore,
in the 15 cases we could evaluate, WFA(+)-M2BP
improved significantly following interferon treatment (from
3.21 to 1.94;P=0.015). Conclusions: In chronic hepatitis C,
WFA(+)-M2BP should prove useful in evaluating relatively early
cases of liver fibrosis. In addition, WFA(+)-M2BP may serve as
an indicator of improvement in liver fibrosis at an early stage.
Disclosures:
The following authors have nothing to disclose: Kohei Oda, Hirofumi Uto, Seiichi
Mawatari, Rie Ibusuki, Sho Ijuin, Hiroka Onishi, Haruka Sakae, Kaori Muromachi,
Akihiko Oshige, Kotaro Kumagai, Tsutomu Tamai, Akihiro Moriuchi, Akio
Ido
1839
Factors Associated with Hepatitis C Virus Infection
among Persons Ages 18 to 29 who Inject Drugs in Suburban
and Rural Wisconsin
David B. Rein 1 , Danielle Liffmann 1 , Jim Brunner 2 , Emily Wievel 2 ,
Gregory Scott 3 , Daniel Raymond 4 , Lisa Danelski 2 , Scott Stokes 2 ,
Joanne E. Brady 1 , Jon E. Zibbell 5 ; 1 NORC at the University of
Chicago, Atlanta, GA; 2 AIDS Resource Center of Wisconsin,
Green Bay, WI; 3 Sociology, DePaul University, Chicago, IL; 4 Harm
Reduction Coalition, New York, NY; 5 Division of Viral Hepatitis,
CDC, Atlanta, GA
Background: Due to national increases in heroin and injection
drug use, along with the recent HIV outbreak among HCV-infected
persons who inject drugs (PWID) in Indiana, information
on behavioral risk factors for HCV infection among young
PWID in non-urban settings is needed. Methods: Between September
2014 and May 2015, we collected survey data and
hepatitis C antibody testing information from young adults ages
18 to 29 who had injected drugs illicitly at least 1 time within
the last year. Using a respondent driven snowball sampling
design, the study collected HCV antibody status using rapid test
kits donated by OraSure® as well as self-reported information
on demographics, injecting behaviors, social network size,
personal characteristics, and drug using histories. This initial
analysis estimated descriptive statistics and stepwise multivariate
logistic regressions (using an alpha of 0.05 for selection)
of the risk of HCV infection. For selection, we included demographics,
number of lifetime injections, history of ever sharing
needles, filters, mix water, or cottons, seeing other people’s
blood while injecting, reported size of injecting network, a
history of ever injecting heroin, prescription opioids, cocaine,
and methamphetamines, and scores on abbreviated scales of
self-efficacy, extroversion, addiction, sensation seeking, and
socio-normative aspirations. Results: Through May, 2015,
we enrolled 265 persons: 58.4% male, 81.9% white, 14.7%
American Indian and 3.4% of other races, with a mean age
of 23.4. Of those, 34.0% were HCV+, 56.2% reported more
than 100 lifetime injections, and 66.4%, 55.9%, 59.3%, and
46.4% reporting ever sharing needles, filters, mix water, and
cookers respectively. In multivariate analyses, injecting more
than 100 times (OR 4.9; 95% CI 2.7-9.2) and having ever
injected cocaine (OR 2.7; 95% CI 1.4-4.9) were significantly
related to HCV+. Among those with less than 100 lifetime injections,
sharing mix water (OR 4.6; 95% CI 1.3-16.1), injecting
heroin (OR 9.5; 95% CI 1.0-89.3), and injecting cocaine
(OR 4.3; 95% CI 1.2-15.3) were significantly associated with
HCV+. Among persons who reported more than 1,000 lifetime
injections, sharing filters (OR 3.1; 95% CI 1.3-7.5) and
injecting cocaine (OR 3.7, 95% CI 1.3-10.0) were significantly
associated with HCV+. Conclusions: We identified an HCV+
prevalence 34.0% among rural/suburban PWID ages 18 to
29. Injecting cocaine was significantly associated with HCV
antibody positivity in the full population. Sharing injection
equipment other than syringes was significantly associated with
higher HCV+ risk when the sample was stratified by number of
lifetime injections.
Disclosures:
David B. Rein - Grant/Research Support: Gilead Sciences, Inc.
Daniel Raymond - Grant/Research Support: Gilead, Janssen
The following authors have nothing to disclose: Danielle Liffmann, Jim Brunner,
Emily Wievel, Gregory Scott, Lisa Danelski, Scott Stokes, Joanne E. Brady, Jon
E. Zibbell
1840
Hyperbilirubinemia in HIV-HCV Co-infected Patients on
cART - Drug Effect or Liver Disease Severity?
Mathew Kaspar, Richard K. Sterling; Virginia Commonwealth University,
Richmond, VA
Background: Hyperbilirubinia (HB) is common and a known
side effect of many medications used in the management of
HIV, particularly the protease inhibitors (PI) Atazanavir and
Indinavir. While typically benign, the sudden development of
HB in HIV-HCV presents a unique challenge to determine if it
is a benign drug effect, related to liver disease progression, or
combination of the two. To date, there have been no studies
investigating the impact of underlying liver histology to distinguish
drug effect from progression of liver disease in the
HIV-HCV population. Objective: To determine if HB in the HIV-
HCV pts being treated with PI is primarily due to drug effect,
progression of liver disease, or both. Methods: We performed
a retrospective analysis of 344 HIV-HCV pts undergoing liver
biopsy. Pts with HBsAg +, hepatic decompensation, or HCC
were excluded. Demographic, clinical, laboratory, and biopsy
data were collected. The primary endpoint was HB (defined as
serum bilirubin greater than 1.2mg/dL, the ULN). Univariate
and multivariate analyses was used to determine factors associated
with HB. Advanced fibrosis (AF) was defined by F3 or
F4 histology (Knodell). Results: The mean age was 46 years,