CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

576 INFLUENCE OF DAA THERAPY ON ALT LEVELS IN HCV- AND HIV/HCV-INFECTED PATIENTS (GECCO)

Stefan Mauss 1 , Christoph Boesecke 2 , Florian Berger 1 , Patrick Ingiliz 3 , Thomas Lutz 4 , Knud Schewe 5 , Malte Wehmeyer 6 , Axel Baumgarten 3 , Jürgen K Rockstroh 7 , Stefan Christensen 8 1 Cntr for HIV and Hepatogastroenterology, Duesseldorf, Germany, 2 Univ Hosp Bonn, Bonn, Germany, 3 Cntr for Infectiology, Berlin, Germany, 4 Infektiologikum, Frankfurt, Germany, 5 dagnae e. V., Berlin, Germany, 6 I. Univ Hosp Hamburg–Eppendorf, Hamburg, Germany, 7 Bonn Univ Hosp, Bonn, Germany, 8 CIM Infectious Diseases, Münster, Germany Background: The definition of normal ALT is under debate and currently not defined by the absence of pathological conditions, but rather by random selection of individuals considered healthy. In the case of chronic hepatitis C a relevant proportion of patients exhibit normal ALT levels before therapy. On the other hand in some patients ALT remains elevated despite eradication of HCV. The purpose of this study is to assess the effect of treating chronic hepatitis C with directly-acting agents (DAA) on ALT levels. Methods: GECCO cohort is a multicenter cohort from 9 sites in Germany enrolling consecutively patients on DAA therapy. In this analysis all patients with documented ALT at baseline and sustained virologic response (SVR12) 12 weeks after end of therapy (EOT) were included. Normal ALT was defined < 35 U/l. For statistical analysis Fishers exact chi- square and Mann-Whitney U test were used. Results: HIV coinfection was present in 266/1263 (21%) with 99% on cART, 766/1263 (61%) were male. Median age 53 years, BMI 24.5 kg/sqm, ALT 66 U/l. HCV genotype (GT) distribution: GT1 74%, GT2 3%, GT3 17%, GT4 6%. HCV RNA >6 Mio IU/ml 238/1263 (19%) HCV pretreatment 578/1263 (47%), liver cirrhosis 328/1263 (26%), Diabetes mellitus 78/1263 (6%), regular alcohol consumption 112/402 (28%), opiate substitution therapy (OST) for 227/1263 (18%). At baseline ALT was <35 U/L in 191/1263 (15%). The course of ALT in patients with low and high ALT is shown in table 1. At SVR12 186/1263 (15%) still had ALT ≥35 IU/ml. In univariate analysis neither high HCV RNA (p=0.6), HIV coinfection (p=0.8), Diabetes (p=0.2), regular alcohol use (p=0.12), or OST (p=0.8) were associated with elevated ALT. However, male sex (p<0.001), ≥60 years (p=0.038), BMI ≥30 kg/ sqm (p<0.001), GT2 (p=0.013), baseline ALT ≥35 U/l (p<0.001), treatment experienced (p=0.017) and liver cirrhosis (p<0.001) were associated with elevated ALT. In multivariate analysis sex (p<0.001), BMI ≥30 (p<0.001), GT2 (p=0.026) and liver cirrhosis (p<0.001) remained statistically significant. Conclusion: Successful DAA treatment in patients with normal ALT levels at baseline achieves considerable ALT reductions indicating an ongoing necroinflammation even in these patients. Elevated ALT at SVR12 was mainly correlated with conditions known to be associated with higher ALT. Being HIV-coinfected and being treated with antiretrovirals however was not associated with elevated ALT after SVR.

577 HIGH PREVALENCE OF HEPATITIS DELTA VIRUS AMONG CAMEROONIAN HBSAG-POSITIVE SPECIMENS

Mary Rodgers 1 , Kelly Coller 1 , Ka-Cheung Luk 1 , Emily Butler 1 , Jill Fuhrman 1 , Elizabeth Krilich 2 , Devin Barnaby 2 , Nicaise Ndembi 3 , Lazare Kaptue 4 , Gavin Cloherty 1 1 Abbott Labs, Abbott Park, IL, 2 Franciscan Univ of Steubenville, Stuebenville, OH, 3 Inst for Human Virology Nigeria, Abuja, FCT, 4 Univ of Montagnes, Bangangté, Cameroon Background: Hepatitis Delta (HDV) is a defective RNA virus that requires Hepatitis B surface antigen (HBsAg) for productive infection. An estimated 15-20 million people are infected with HDV worldwide; however, limited data are available on the prevalence of this virus in sub-Saharan Africa where HIV infection rates are high. HDV/HBV/HIV co-

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