studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1107A
of increasing the number of PWIDs treated with new oral DAAs
was considered, including the annual number needed to treat
in order to reduce the HCV-infected PWID population by 2030.
Results: If the current transmission paradigm continues, there
are projected to be 3,620 HCV infected PWIDs in 2030.
Annually treating 40 HCV-infected PWIDs with new oral DAAs
(1% of HCV-infected PWID population in 2014) resulted in a
5% reduction in HCV-infected PWIDs by 2030, while annual
treatment of 200 PWIDs (5% of 2014 population) resulted in a
reduction of over 25% by 2030. Treating 387 PWIDs annually
(17% of 2014 population) resulted in a >90% reduction in
HCV-infected PWIDs by 2030. Targeting treatment to PWIDs
engaged in OST and NEP would provide the greatest reduction
in prevalence for the number of individuals treated (2.2 treated
in OST/NEP to reduce prevalence by 1, as compared with 6.8
treated in the general population). Conclusions: The results
show that treating yet a small amount of PWIDs resulted in
substantial decreases in the HCV infected PWID population by
2030. Furthermore, the relative impact of treatment was greatest
when focused on the population engaged in OST and NEP.
Treatment is expected to increase the rate of reinfection; however,
reinfection will decline as HCV prevalence decreases.
This analysis supports the implementation of a screening and
treatment strategy among PWIDs when combined with an
expansion of harm reduction programs.
Disclosures:
Stefan Bourgeois - Advisory Committees or Review Panels: AbbVIe, Gilead; Consulting:
Roche, MSD; Speaking and Teaching: Janssen, BMS
Sarah Blach - Employment: Center for Disease Analysis
Homie Razavi - Management Position: Center for Disease Analysis
Geert Robaeys - Advisory Committees or Review Panels: Gilead; Speaking and
Teaching: Merck, Janssens
The following authors have nothing to disclose: Catharina Mathei, Christian
Brixko, Jean-Pierre Mulkay, Thomas Sersté
1843
Non-Invasive Fibrosis Scores: Do They Predict Antiviral
Treatment Response, Decompensation, Hepatocellular
Carcinoma and Significant Liver Related Adverse Events
in Chronic Hepatitis C?
Ragesh B. Thandassery 1 , Madiha E. Soofi 1 , Anil John 1 , Samir S.
Nairat 1 , Abdulrahman A. Alfadda 2 , Saad R. Al Kaabi 1 ; 1 Hamad
Medical Corporation, Doha, Qatar; 2 King Faisal Specialist Hospital
and Research Center, Riyadh, Saudi Arabia
Background The role of non-invasive liver fibrosis scores (NIF)
in predicting antiviral treatment (AVT) response and post treatment
significant liver related events (SLRE) in chronic hepatitis
C (CHC) is less studied. Aim To compare 12 simple NIF,
derived from routine blood investigations, for predicting
response to AVT and SLRE. Methods 1605 patients underwent
liver biopsy (LB, Scheuer classification) and received AVT
(pegylated interferon and ribavirin). 12 NIF [AST-platelet count
ratio index (APRI), Fibrosis-4 (FIB-4) score, Lok score, GUCI
score, Fibroalpha score, modified APRI, King score, AST-ALT
ratio (AAR), Fibrosis Index (FI), Fibro score, Fibrosis cirrhosis
index (FCI) and Globulin platelet index (GPI)] were calculated
prior to AVT. AUROCs were calculated for each of these NIF
for predicting non-response to AVT and development of SLRE
(defined as development of any event requiring intervention;
decompensation and hepatocellular carcinoma, HCC) on
follow-up Results Mean age 41.9years, predominantly genotype
4(65%).1089(67.8%) were responders, 482(30%) non
responders and 34(2.1%) relapsers. After median follow-up of
6580.5 patient-years; 52(3.2%) had decompensation (bleed-
9, ascites-39, jaundice-22, hepatic encephalopathy-7, spontaneous
bacterial peritonitis-10, hepatorenal syndrome-4),
11(0.7%) had HCC and 60(3.7%) had SLRE. The predictive
accuracy of NIF and LB for non-response to AVT was low.
FibroQ, King score and FIB-4 showed high accuracy for predicting
adverse events. For predicting decompensation, HCC
and SLRE, FibroQ (0.88), King score (0.90) and FibroQ (0.87)
had highest AUROC respectively. Conclusions Predictive accuracy
of NIF for non-response to treatment was low. Some NIF
have high accuracy for predicting development of decompensation,
HCC and SLRE on follow-up. Application of these simple
scores can improve assessment of liver prognosis in patients
treated for CHC.
Non-invasive scores in predicting post treatment events
* AUROC(95% Confidence interval)
Disclosures:
The following authors have nothing to disclose: Ragesh B. Thandassery, Madiha
E. Soofi, Anil John, Samir S. Nairat, Abdulrahman A. Alfadda, Saad R. Al Kaabi