studies

1132A AASLD ABSTRACTS HEPATOLOGY, October, 2015
inner city groups. METHODS: We have established a multi-disciplinary
outreach program to recruit and retain HIV/HCV-infected
PWID in care. The program includes access to specialty
medical care, extended social support services, complimentary
over-the-counter medications and vitamins, daily snacks/beverages,
and weekly meals and HIV/HCV support groups. HIV
and HCV treatment is offered to all who qualify for it on medical
grounds. We have conducted a retrospective analysis of
all HIV co-infected patients treated for HCV infection within our
program and for whom a definite HCV treatment outcome was
ascertained. This analysis correlates SVR with a range of baseline
demographic and clinical variables, including housing and
active recreational drug use. RESULTS: Of 512 HIV-infected
individuals in our program, 245 (47.9%) are co-infected with
HCV, including 172 (70.2%) active (current/recent) PWID.
In total, 75 (30.6%) have completed HCV treatment (5 on alloral
regimens), including 55 (73.3%) active PWID, and 46
(61.3%) with genotype 1 infection. The mean age was 51, 70
(93.3%) male, 22 (26.7%) on opiate substitution, 72 (96.0%)
on HIV treatment (62/72 with full virologic suppression), 20
(27.8%) homeless, and 32 (42.7%) attending weekly HCV
support groups. The SVR rate was 43.1% (31/72), 80% (4/5)
in genotype 1 patients on all-oral regimens. SVR was higher
in non-genotype 1 (54.5% vs. 43.1%) patients. Success rates
were no higher in subjects on methadone 12 (54.5%), and no
lower in the homeless 10 (50.0%) or active PWID 25 (45.5%).
SVR was over 56% in active support group participants. An
additional 9 co-infected patients have been started on all-oral
regimens, and SVR data will be presented. DISCUSSION: In our
centre, >35% of HIV/HCV co-infected patients (mostly PWID)
have been treated for HCV infection. Many of the usual negative
predictive factors do not affect treatment success, a fact
that may be linked to the low-barrier multi-disciplinary nature
of our program. There is a trend towards increased success in
patients more actively engaged in our program. Our model will
provide an opportunity for vulnerable populations to benefit
from treatment for both HIV and HCV infections.
Disclosures:
Brian Conway - Advisory Committees or Review Panels: Vertex Pharmaceuticals,
Merck, Boehringer Ingelheim, Jannsen Pharmaceuticals; Grant/Research Support:
Vertex Pharmaceuticals, Merck, Boehringer Ingelheim, Jannsen Pharmaceuticals,
AbbVie, Gilead Sciences, Gilead Sciences
time intervals until postoperative recurrence (within 2 years,
after 2 years or later, and no recurrence). (1) The maximum
standardized uptake value (SUV max) of tumor was assessed
and the best cut-off value of SUV max for predicting MVI was
obtained using receiver operating characteristic (ROC) curve.
Independent predictors for MVI were identified by multivariate
analysis. (2) Using the best cut-off value of SUV max for predicting
MVI, the associations between SUV max and recurrence
patterns and intervals were analyzed. Results: (1) 31 of 79
(39.2%) patients showed positive preoperative PET-scans and
the mean SUV max was 3.15 ± 1.28 (range, 2−8.8). MVI
was present in 13 of 79 patients (16.5%) on pathologic examination.
SUV max ≥5.0 was suggested to be the best cut-off
value for predicting MVI by ROC curve (area under the curve
[AUC] =0.712, sensitivity=46.1%, specificity=90.6%). Multivariate
analysis showed that SUV max ≥5.0 (p=0.05), AFP-
L3 ≥15% (p=0.02), and non-simple nodular as macroscopic
classification (p=0.039) were independent predictors for MVI.
(2) SUV max in the recurrence within the MC (3.25±0.94)
and no recurrence group (2.92±0.86) was significantly lower
than that in the recurrence beyond the MC group (4.98±2.79).
Multivariate analysis showed that SUV max ≥5.0 (p=0.002)
was an independent predictor for recurrence beyond the MC.
SUV max in the group with recurrence after 2 years or later
(3.45±1.56) and no recurrence (2.92±0.86) was significantly
lower than that in the within 2 years group (4.06±2.14). Multivariate
analysis showed that SUV max ≥5.0 (p=0.002) and
tumor size ≥30mm (p=0.026) were independent predictors for
recurrence within 2 years. Conclusions: Preoperative 18 F-FDG
PET-CT predicts MVI, recurrence beyond the MC, and recurrence
within 2 years after curative HR for early-stage HCC.
Disclosures:
Kazuaki Chayama - Consulting: AbbVie; Grant/Research Support: Ajinomoto,
Astellas, Torii, Tsumura, Aska, Bayer, Zeria, Daiichi Sankyo, Dainippon Sumitomo,
Eisai, Eli Lily, Janssen, Kowa, Mitsubishi Tanabe, MSD, Nippon Kayaku,
Nippon Shinyaku, Otsuka, Roche, Takeda, Toray; Speaking and Teaching:
Ajinomoto, AbbVie, Abott, Astellas, AstraZeneca, Aska, Bayer, BMS, Chugai,
Daiichi Sankyo, Dainippon Sumitomo, Eisai, J & J, Jimro, Miyarisan, MSD, Nihon
Kayaku, Olympus
The following authors have nothing to disclose: Tomoki Kobayashi, Hiroshi
Aikata, Fumi Shinohara, Norihito Nakano, Yuki Nakamura, Masahiro Hatooka,
Kei Morio, Reona Morio, Takayuki Fukuhara, Yuuko Nagaoki, Tomokazu Kawaoka,
Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami
1893
High 18 F-FDG uptake on preoperative PET-CT correlates
with microvascular invasion and predicts early and
massive recurrence after curative resection for early-stage
hepatocellular carcinoma
Tomoki Kobayashi, Hiroshi Aikata, Fumi Shinohara, Norihito
Nakano, Yuki Nakamura, Masahiro Hatooka, Kei Morio, Reona
Morio, Takayuki Fukuhara, Yuuko Nagaoki, Tomokazu Kawaoka,
Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Kazuaki
Chayama; Department of Gastroenterology and Metabolism, Hiroshima
University Hospital, Hiroshima, Japan
BackgroundAim: Microvascular invasion (MVI) predicts recurrence
beyond the Milan criteria (MC) and early recurrence
after hepatic resection (HR) for hepatocellular carcinoma
(HCC). Recently, several studies have shown that 18 F-FDG
uptake may be a surrogate marker for MVI. This study aimed to
assess the value of preoperative 18 F-FDG PET-CT for predicting
recurrence patterns and intervals after HR in early-stage HCC.
Methods: 79 consecutive patients who were preoperatively
examined with 18 F-FDG PET-CT and underwent curative HR for
HCC within the MC were enrolled in this retrospective cohort
study. They were classied according to the recurrence patterns
(beyond the MC and within the MC or no recurrence) and the
1894
Reduced sensitivity of ultrasound in detecting hepatocellular
carcinoma in obese patients, using explants
pathology as gold standard
Jamak Modaresi Esfeh 2 , Kaveh Hajifathalian 1 , Kianoush Ansari-Gilani
3 , Ahyoung Kim 1 , Carlos J. Romero-Marrero 2 ; 1 Internal Medicine,
Cleveland clinic, Beachwood, OH; 2 Gastroenterology and
Hepatology, Cleveland Clinic, Cleveland, OH; 3 Diagnostic Radiology,
University Hospitals, Case Medical Center, Cleveland, OH
Background: American Association for the Study of Liver
Diseases (AASLD) recommends screening for hepatocellular
carcinoma (HCC) among patients with cirrhosis to be done
with ultrasound (US) every six months, regardless of their BMI.
We examined the sensitivity of US for diagnosis of HCC in
obese patients. Methods: We used the prospective data from
liver transplant patients between January 2005 and December
2010, who were diagnosed with HCC in the pathologic examination
of their explants. All patients had US studies of their
liver within six months of diagnosis of HCC. Number and size
of HCC lesions were extracted from radiologic and pathologic
reports. Obesity was defined based on BMI≥30 kg/m 2 . Results:
99 patients, 22% female, with mean BMI of 31 kg/m 2 (range
20-43) were included. Most common underlying liver disease