studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1127A
lower limit of quantification of 25 IU/mL. Results: A total of
816 individuals with detectable serum HCV-RNA were identified.
The main characteristics of this population were as follows:
mean age: 48.6±6.9 years-old; male gender 73.4%;
mean ALT: 82.6±70.9 IU/L; mean HCV-RNA: 6.02±0.75 log
IU/mL; HCV genotypes 1 or 4: 80.6%; mean liver stiffness:
11.3±10.4 kPa; advanced liver fibrosis (>9.5 kPa): 34.9%;
IL28B-CC: 35.4%. HIV coinfection was found in 78.7% (mean
CD4 count: 496±295 cells/uL; HAART: 91%). Overall, 127
(15.6%) had serum HCV-RNA values >6 million IU/mL. This
high viremia was found in 18.2% of HIV-positive versus 5.7%
of HIV-negative (p6 million IU/mL were as follows: mean age
48.2±5.2 years-old; male gender 78.7%, HCV genotypes 1-4:
87.6%; advanced liver fibrosis 33.6%; IL28B-CC 41.1%; and
HIV pos 92.1%. In multivariate analysis, serum HCV-RNA >6
million IU/mL was only significantly associated with HIV coinfection
(OR: 4.03; 95% CI: 1.98-8.19, p6 million IU/mL is overall seen
in 6% of chronic hepatitis C patients, being significantly more
frequent in patients with HIV coinfection (18%) and/or with
HCV genotypes 1/4 (10%).
Disclosures:
The following authors have nothing to disclose: Pablo Barreiro, Pablo Labarga,
Jose V. Fernandez-Montero, Carmen de Mendoza, Laura Benitez, Jose M Peña,
Vincent Soriano
1882
Acute hepatitis and reactivation of hepatitis C virus in
cancer patients receiving systemic chemotherapy
Hae Lim Lee, Si Hyun Bae, Hyun Yang, Jeong Won Jang, Jong
Young Choi, Seung Kew Yoon; the catholic university of Korea,
Seoul, Korea (the Republic of)
Introduction : Reactivation of hepatitis C virus (HCV) is less
common and only a few cases with severe consequences have
been reported compared to HBV infection when it comes to
receiving systemic chemotherapy. Many reported studies suggested
that HCV reactivation was associated with chemotherapy
containing rituximab and/or steroids. This retrospective
study was aim to characterize acute exacerbation of HCV
infection in cancer patients receiving systemic chemotherapy.
Patients and methods : A total of 102 patients reviewed from
January 1, 2008 to March 1, 2015 at Seoul St. Mary’s hospital,
positive for anti-HCV antibody and receiving systemic chemotherapy
for cancer except hepatocellular carcinoma, were
included. 7 patients who lack HCV RNA titers were excluded.
Hepatitis was defined as over three fold increase in ALT level.
HCV reactivation was defined as reappearance of RNA which
was previously undetected or resolved or RNA increasd over
10 fold compared with the baseline level. Results : Among the
95 patients with HCV infection and cancer, 53 patients (56%)
showed hepatitis of all cause. 23(43%) of the 53 patients had
hematological tumors and these were DLBCL(6, 11%), acute
leukemia(n=11, 20%) and others(n=6, 11%). 14(33%) of the
42 patients without hepatitis had hematological tumor. Neither
severe hepatitis nor hepatic decompensation was noted. 32
patients had RNA level determination before and after chemotherapy.
HCV reactivation was noted in 10 patients (31%).
Among them, no patient (0/10) with acute leukemia regardless
of stem cell transplantation was identified to have HCV
reactivation. In univariate analysis for HCV reactivation, no
statistically significant factor was found. In 4 of 10 patients,
hepatitis was documented in the period of HCV reactivation. 2
patients were diagnosed as DLBCL and had received R-CHOP
for chemotherapy regimen. Others were breast cancer and
malignant melanoma. Conclusion : Cancer patients with HCV
infection can be generally treated with systemic chemotherapy.
Although systemic chemotherapy can induce hepatitis and HCV
reactivation, no severe hepatitis or hepatic decompensation
was documented, thus it might have less clinical significance
compared to HBV infection.
Disclosures:
The following authors have nothing to disclose: Hae Lim Lee, Si Hyun Bae, Hyun
Yang, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon
1883
Healthcare Utilization and Costs among Hepatitis C
Patients with and without Impaired Renal Function in
the United States
Senaka Peter 1 , Craig Solid 2 , Tanya Bovitz 2 , Haifeng Guo 2 , Allan
J. Collins 2 , Jean Marie Arduino 1 ; 1 Merck & Co., Inc., Kenilworth,
NJ; 2 Chronic Disease Research Group, Minneapolis, MN
Purpose: To compare rates of healthcare utilization and costs
among US commercially-insured patients with hepatitis C virus
(HCV) infection with and without renal impairment. Methods:
This cross-sectional analysis used Truven MarketScan claims
database to identify an HCV cohort of patients aged 20 to
64 based on ICD-9 diagnosis codes in 2011. Within the
cohort, we identified those with evidence of chronic kidney
disease (CKD) or end-stage renal disease (ESRD) by ICD-9
codes. All-cause healthcare utilization (HCU) and medical
costs for all health encounters excluding pharmacy during
a 1-year follow-up period were evaluated. The subset of allcause
HCU and costs related to HCV were identified as those
claims with a principal diagnosis code for HCV or HCV-related
liver disease. Generalized linear models, adjusted for
patient characteristics and baseline comorbidities, were used
to test for differences in costs. Results: A total of 35,965 HCV
patients (mean age= 53.2 years; 63% male) were identified
in 2011. All-cause and HCV-related HCU in the inpatient and
outpatient settings were substantially higher for HCV patients
with non-ESRD CKD or ESRD compared to HCV patients with
no evidence of renal impairment during the 2012 follow-up
year (Table). Compared to patients without evidence of renal
impairment, all-cause and HCV-related medical costs (Table)
were also significantly higher for those with renal disease, as
demonstrated by adjusted rate ratios of 1.74 and 2.53 (both
p