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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 <strong>studies</strong> 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 <strong>studies</strong> 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
HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1133A was HCV (52%). At diagnosis, median number of HCC lesions was 1 (IQR 1-2) and median size of the largest lesion was 2 cm (IQR 1.5-3.1). Overall sensitivity of an US study for detection of HCC was 38% (95% CI 29-48%). Sensitivity was 77% (95% CI 62-93%) in patients with BMI
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1312A AUTHOR INDEX HEPATOLOGY, Octo
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1366A CATEGORY INDEX HEPATOLOGY, Oc
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