- Email: [email protected]
P778 RESOURCE UTILIZATION DURING HEPATITIS C TREATMENT WITH BOCEPREVIR- OR TELAPREVIR-BASED TRIPLE THERAPY VS DUAL THERAPY IN A LARGE U.S. HEALTH MAINTENANCE ORGANIZATION
POSTERS Methods: The study enrolled 18064 residents aged between 40–75 years old living in seven townships. There were 950 antiHCV seropositives and they were further examined HCV RNA. All participants were followed from 2000 until December, 31, 2010. The incident of diabetes was defined by the ICD-9 code of 250. Person-years at risk were calculated for each person as time from enrollment date to either the date of death or to the end of 2010. Cox’s proportional hazard models were used for estimations of relative risks and 95% confidence intervals of HCV infection in diabetes after controlling for other confounders. Results: After 180,426 person-years of follow-up, there were 2,123 newly developed diabetes cases identified, giving the incidence of 11.8 per 1,000 person-years. The incidence of diabetes was 11.4 and 18.5 per 1,000 person-years for anti-HCV seronegatives and antiHCV seropositives, respectively. The participants seropositive for anti-HCV had increased risk for diabetes, with the adjusted relative risk of 1.62 (1.36–1.91). The multivariate adjusted relative risk was 1.37 (1.04–1.82) and 1.78 (1.45–2.18) for anti-HCV seropositives with undetectable HCV RNA and anti-HCV seropositives with detectable HCV RNA, respectively, by using the anti-HCV seronegatives as the reference group (p for trend <0.001). Conclusions: HCV infection may increase the risk of diabetes. The mechanisms need to be further investigated. P776 REDUCTION OF MIR-122 IN IFNL3 CT+TT CARRIERS AND DURING PROGRESSION OF FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C E. Estrabaud1,2 , M. Lapalus1,2 , P. Broet3 , K. Appourchaux1,2 , S. De Muynck1,2 , O. Lada1,2 , M. Martinot-Peignoux1,2 , I. Bieche4 , D. Valla2 , P. Bedossa5 , P. Marcellin1,2 , M. Vidaud6 , T. Asselah1,2 . 1 CRB 3 INSERM U 773, Paris, 2 Hˆ opital Beaujon, AP-HP, University Paris-Diderot, Service d’H´epatologie, Clichy, 3 University Paris-Sud Inserm UMR 669, and AP-HP, Groupe Hospitalier Antoine-B´ecl`ere – Bicˆetre – Paul-Brousse, Villejuif, 4 UMR745 INSERM, Universit´e Paris Descartes, Sorbonne Paris Cit´e, Facult´e des Sciences Pharmaceutiques et Biologiques, Paris, 5 Hˆ opital Beaujon, AP-HP, University ParisDiderot, Service d’Anatomie Pathologique, Clichy, 6 UMR 745 INSERM, Universit´e Paris Descartes, Sorbonne Paris Cit´e, Facult´e des Sciences Pharmaceutiques et Biologiques, Paris, France E-mail: [email protected] Background and Aims: Mir-122 is highly express, in the liver, and stimulates HCV replication, in vitro. IFNL3 polymorphisms have been associated with response to pegylated-interferon plus ribavirin, in patients with chronic hepatitis C (CHC). Increased mir122 expression has been associated with complete early virological response (cEVR). The aim of the study was to investigate, in vivo, the modification of expression of mir-122 and more specifically the relationship between mir-122 expression, IFNL3 polymorphism and response to treatment. Methods: Pre-treatment liver biopsies and serums from 133 patients with CHC were included. Sixty six patients achieved a SVR, and 64 failed to respond to the treatment (43 non-responders (NR) and 21 relapsers (RR). Mir-122 expression was assessed by RT-q-PCR and IFNL3 rs12979860 by direct sequencing. Results: Hepatic mir-122 expression was higher in CC patients when compared to CT+TT, in total patients (p = 0.025) and in NRs+RRs (p = 0.013). Increased hepatic mir-122 was more strongly associated with cEVR (p = 0.003) than with SVR (p = 0.016). In multivariate analysis hepatic mir-122 was only associated with IFNL3. Serum and hepatic expression of mir-122 were not associated. Mir-122 was decreased in patients with F3–F4 as compared to patients with F1–F2 (p = 0.01). In HCV genotype 1 patients, hepatic mir-122 was higher in F1 compared to F2–F4 (p = 0.01). Mir-122 was reduced during early progression of fibrosis (F0/1 to F1/2).
Conclusions: The association between mir-122 and IFNL3 is stronger than the association between mir-122 and response. Mir122 may play a role in the early viral decline dependent of IFNL3 and innate immune response. P777 DOSE-DEPENDENT PHARMACOKINETICS FOR MK-5172 25 mg, 50 mg, AND 100 mg ONCE-DAILY FOR 12 WEEKS IN HCV GENOTYPE 1 TREATMENT-NAIVE NON-CIRRHOTIC PATIENTS L. Caro1 , J. Talaty1 , M. Morrison2 , S. Zhang2 , Z. Guo3 , I.N. Gendrano III4 , P. Hwang5 , N. Mobashery6 . 1 Quantitative Pharmacology & Pharmacometrics, 2 Early Development Health Economics & Epi, 3 Early Clinical Development Statistics, 4 Clinical Scientist Organization – Infectious Disease, 5 Late-Stage Development – Infectious Disease, 6 Late-Stage Development – Hepatology, Merck & Co., Inc., Whitehouse, NJ, United States E-mail: [email protected] Background and Aims: MK-5172 is a potent hepatitis C virus (HCV) NS3/4A protease inhibitor with a high barrier to resistance. In a Phase 2 study, 89–93% of non-cirrhotic genotype (G)1-infected patients achieved SVR24 after receiving MK-5172 100–800 mg QD plus peg-interferon and ribavirin (PR) for 12 weeks, followed by PR for 12 or 36 weeks. The present study evaluated lower doses and shorter duration of MK-5172. Methods: 87 patients were randomized to MK-5172 25, 50, or 100 mg + PR for 12 weeks; patients with detectable HCV-RNA (>9.3 IU/mL but <25 IU/mL) at treatment week (TW)4 confirmed as <25 IU/mL on retesting received PR for an additional 12 weeks. Plasma samples for MK-5172 PK were collected predose and at 2and 4-hours postdose at select visits through TW12. MK-5172 PK was analyzed for the 25 mg (N = 21), 50 mg (N = 22), and 100 mg (N = 18) doses. Results: The steady-state geometric means (GM) for the 25 mg, 50 mg, 100 mg doses were 7.06, 14.3, 28.1 nM for Ctrough, 13.7, 54.5, 264 nM for C2hr, and 12.8, 40.0, 200 nM for C4hr. Conclusions: The MK-5172 plasma exposure in GT1 HCV patients demonstrated greater than dose-proportional increases in exposures across the 25-, 50-, and 100-mg doses. The dosedependent PK is consistent with a dose-dependent response observed for SVR4 (73% for 25 mg, 88% for 50 mg, and 92% for 100 mg). The non-linear PK behavior of MK-5172 is consistent with observations at higher doses in GT1 HCV patients and in studies in healthy subjects. P778 RESOURCE UTILIZATION DURING HEPATITIS C TREATMENT WITH BOCEPREVIR- OR TELAPREVIR-BASED TRIPLE THERAPY VS DUAL THERAPY IN A LARGE U.S. HEALTH MAINTENANCE ORGANIZATION L.M. Nyberg1 , K.M. Chiang2 , Z. Li2 , A.H. Nyberg1 , Z.M. Younossi3 , T.C. Cheetham2 . 1 Hepatology Research, Kaiser Permanente, San Diego, 2 Pharmacy Analytical Services, Kaiser Permanente, Downey, CA, 3 Department of Medicine, Inova Fairfax Hospital, Center for Liver Diseases, Falls Church, VA, United States E-mail: [email protected] Background and Aims: Chronic hepatitis C (HCV) treatment uses substantial health care (HC) resources. The aim of this study was to determine resource utilization before and during HCV treatment with peginterferon and ribavirin (dual) and with either boceprevir or telaprevir with peginterferon and ribavirin (triple). Methods: Retrospective cohort study using data from Kaiser Permanente Southern California including participants ≥ 18 years old with a diagnosis and/or positive lab result for HCV RNA and ≥ 6 months continuous membership plus drug benefit prior to HCV treatment. HC utilization was determined 6 months prior to treatment and during treatment using an
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POSTERS electronic algorithm tabulating emails, telephone encounters, hospitalizations, emergency (ED) and office visits, labs, and new prescriptions. HC utilization for dual vs. triple therapy was compared. Results: From Jan 2002 through Dec 2012, 44,442 HCV patients were identified. After applying inclusion criteria, 6,759 treatment courses were identified in 6,341 patients. 6,355 treatment courses were dual and 404 were triple (172 boceprevir/232 telaprevir). 5,810 dual and 269 triple courses were in treatment-naive patients. A significant increase in pre-treatment outpatient visits was seen for triple vs dual therapy (9.01±5.56 vs 6.78±5.37, p ≤ 0.001). During treatment, triple therapy was associated with significantly greater HC utilization than dual therapy. Email encounters were also 2–3 times higher in triple vs dual therapy (Table 1). Table 1. Resource utilization during antiviral therapy Average utilization (per person)
ER count Pre-treatment Days 0–89 Days 90–179 Hospitalization Pre-treatment Days 0–89 Days 90–179 Outpatient visits Pre-treatment Days 0–89 Days 90–179 Lab tests Pre-treatment Days 0–89 Days 90–179 Prescription drugs Pre-treatment Days 0–89 Days 90–179 Average e-mail encounters Pre-treatment Days 0–89 90–179
Dual therapy
Triple therapy With BOC
With TVR
0.19 0.15 0.12
0.17 0.11 0.16
0.19 0.28 0.15
0.05 0.02 0.02
0.04 0.01 0.01
0.03 0.02 0.03
6.78 4.56 3.79
9.12 6.91 5.12
8.22 5.67 4.60
77.61 115.37 96.39
63.72 130.79 119.83
64.61 152.04 120.35
7.48 11.79 10.24
7.10 14.69 11.94
7.22 14.78 8.91
0.09 0.28 0.27
0.22 1.03 0.80
0.24 0.65 0.64
Conclusions: Health care resource utilization was significantly increased with triple vs dual therapy. Future treatment may require less HC resources due to expected shorter treatment duration and better side effect profiles. P779 PLATELET COUNT/SPLEEN DIAMETER RATIO (PSR) AS A PREDICTOR OF LIVER RELATED DECOMPENSATION IN PATIENTS WITH CHRONIC HEPATITIS C (CHC) AND LOW PLATELET COUNT F. Fernandes, G. Pereira, Z. Veiga, D. Martins, A. Campos, J.C. Lino, J.L. Pereira. Gastroenterology and Hepatology Unit, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil E-mail: ffernandes.fl[email protected] Background and Aims: PSR is a simple, non-invasive index, proposed to evaluate the presence of esophageal varices (EV). Our aim was to evaluate the PSR as a predictor of liver related decompensation in CHC outpatients. Methods: 76 CHC patients with platelets below 150.000 were submitted to upper endoscopy, abdominal sonography and blood evaluation. During a follow-up of 2 years, incidence of decompensations was registered and associated factors evaluated with the Cox Model. Results: Mean age was 57±11 years and 53% were females. Mean spleen size, platelets and PSR was 119±23 mm, 110±34×109 /L and 956±383, respectively. Mean bilirubin, albumin, INR and MELD S330
were: 1.2±0.6 mg/dL, 4.4±0.5 g/dL, 1.1±0.1 and 9±2, respectively. Most patients were Child A (95%) and 34% had EV. After two years, 11 patients had decompensated (ascites, hepatic encephalopathy and variceal bleeding in 6, 3 and 2, respectively). There were 3 deaths. On univariate analysis PSR, albumin and EV predicted decompensations (p value 0.020, 0.080 e 0.009, respectively). On multivariate analysis PSR below 1000 was the only independent predictor (HR 9.0 IC95% 1.1–7.1, p 0.037). The best cut-off points for PSR and albumin were 1000 (HR 8.6 (IC 95% 1.1–1.68)) and 4.4 (HR 4.8 (IC 95% 1.2–18.6)), respectively. Probability of decompensations with PSR higher or lower than 1000 was, respectively, 97 and 77% (p 0.013). Conclusions: CHC patients with thrombocytopenia have a high prevalence of EV and are very prone to decompensate. Amongst then, PSR can identify no invasively a subgroup of patients with high probability of developing liver related complications. P780 TRENDS IN THE SEROPREVALENCE OF HBV, HCV AND HIV INFECTION AT A REFERENCE MEDICAL AREA IN SPAIN OVER THE LAST FIVE YEARS 2 ´ Mena De Cea1 , L. Moldes Suarez2 , M. Perez-Abeledo ´ , I. Torres A. 2 3 2 Beceiro , H. Meijide , A. Canizares ˜ Catellanos , A. Castro-Iglesias1 , 2 1 1 J.D. Pedreira Andrade1 , G. Bou Arevalo ´ , E. Poveda Lopez ´ . Division of Clinical Virology, INIBIC-Complexo Hospitalario Universitario de A Coru˜ na, 2 Service of Microbiology, INIBIC-Complejo Hospitalario Universitario de A Coru˜ na, 3 Service of Internal Medicine, Hospital Quiron, Coru˜ na A, Spain E-mail: [email protected] Background and Aims: The seroprevalence of HBV, HCV and HIV in individuals attending a reference medical area in Spain during the last 5 years have been assessed. Methods: HBV, HCV and HIV serological markers were recorded at our reference lab ordered from primary care and specialized physicians between 2008–2012. Demographic and laboratory parameters were documented. Results: 131,544 HBsAg results were generated within the last 5 years, HBsAg prevalence was 1.6% remaining stable: 1.6% (2008), 1.7% (2009), 1.6% (2010), 1.6% (2011), and 1.5% (2012). HBsAg+ individuals were mostly (61.5%) male, mean age 45±17 years and 12.5% HBeAg+. From 92,143 anti-HCV-Ab results from this period, anti-HCV+ rate was 8.6% remaining stable: 8.2% (2008), 7.4% (2009), 7.8% (2010), 8% (2011), and 10.1% (2012). Conversely to USA data (highest rates of anti-HCV+ in persons born between 1945–1965), the highest rates of anti-HCV-Ab+ were observed between 1960–1975. Anti-HCV-Ab+ individuals were male (51.7%), mean age 45±18 years, and 56.3% viremic. HCV genotype distribution was: 59.7% G1, 5.4% G2, 22.7% G3, and 12.2% G4. From 65,279 anti-HIV-Ab results generated in this period, the antiHIV+ rate was 1.1% remaining stable: 1.1% (2008), 1.3% (2009), 1.4% (2010), 0.8% (2011), 1% (2012). The highest rates of anti-HIV+ were found for persons born between 1960–1975, similarly to that found for anti-HCV+. Conclusions: A relatively high prevalence of HBsAg, anti-HCV+, and anti-HIV+ (1.6%, 8.6%, and 1.1%, respectively) was observed in persons requiring medical care in Northern Spain. Conversely to USA data, highest rates of HCV exposure were observed in subjects born between 1960–1975.
Journal of Hepatology 2014 vol. 60 | S215–S359
Conclusions: The association between mir-122 and IFNL3 is stronger than the association between mir-122 and response. Mir122 may play a role in the early viral decline dependent of IFNL3 and innate immune response. P777 DOSE-DEPENDENT PHARMACOKINETICS FOR MK-5172 25 mg, 50 mg, AND 100 mg ONCE-DAILY FOR 12 WEEKS IN HCV GENOTYPE 1 TREATMENT-NAIVE NON-CIRRHOTIC PATIENTS L. Caro1 , J. Talaty1 , M. Morrison2 , S. Zhang2 , Z. Guo3 , I.N. Gendrano III4 , P. Hwang5 , N. Mobashery6 . 1 Quantitative Pharmacology & Pharmacometrics, 2 Early Development Health Economics & Epi, 3 Early Clinical Development Statistics, 4 Clinical Scientist Organization – Infectious Disease, 5 Late-Stage Development – Infectious Disease, 6 Late-Stage Development – Hepatology, Merck & Co., Inc., Whitehouse, NJ, United States E-mail: [email protected] Background and Aims: MK-5172 is a potent hepatitis C virus (HCV) NS3/4A protease inhibitor with a high barrier to resistance. In a Phase 2 study, 89–93% of non-cirrhotic genotype (G)1-infected patients achieved SVR24 after receiving MK-5172 100–800 mg QD plus peg-interferon and ribavirin (PR) for 12 weeks, followed by PR for 12 or 36 weeks. The present study evaluated lower doses and shorter duration of MK-5172. Methods: 87 patients were randomized to MK-5172 25, 50, or 100 mg + PR for 12 weeks; patients with detectable HCV-RNA (>9.3 IU/mL but <25 IU/mL) at treatment week (TW)4 confirmed as <25 IU/mL on retesting received PR for an additional 12 weeks. Plasma samples for MK-5172 PK were collected predose and at 2and 4-hours postdose at select visits through TW12. MK-5172 PK was analyzed for the 25 mg (N = 21), 50 mg (N = 22), and 100 mg (N = 18) doses. Results: The steady-state geometric means (GM) for the 25 mg, 50 mg, 100 mg doses were 7.06, 14.3, 28.1 nM for Ctrough, 13.7, 54.5, 264 nM for C2hr, and 12.8, 40.0, 200 nM for C4hr. Conclusions: The MK-5172 plasma exposure in GT1 HCV patients demonstrated greater than dose-proportional increases in exposures across the 25-, 50-, and 100-mg doses. The dosedependent PK is consistent with a dose-dependent response observed for SVR4 (73% for 25 mg, 88% for 50 mg, and 92% for 100 mg). The non-linear PK behavior of MK-5172 is consistent with observations at higher doses in GT1 HCV patients and in studies in healthy subjects. P778 RESOURCE UTILIZATION DURING HEPATITIS C TREATMENT WITH BOCEPREVIR- OR TELAPREVIR-BASED TRIPLE THERAPY VS DUAL THERAPY IN A LARGE U.S. HEALTH MAINTENANCE ORGANIZATION L.M. Nyberg1 , K.M. Chiang2 , Z. Li2 , A.H. Nyberg1 , Z.M. Younossi3 , T.C. Cheetham2 . 1 Hepatology Research, Kaiser Permanente, San Diego, 2 Pharmacy Analytical Services, Kaiser Permanente, Downey, CA, 3 Department of Medicine, Inova Fairfax Hospital, Center for Liver Diseases, Falls Church, VA, United States E-mail: [email protected] Background and Aims: Chronic hepatitis C (HCV) treatment uses substantial health care (HC) resources. The aim of this study was to determine resource utilization before and during HCV treatment with peginterferon and ribavirin (dual) and with either boceprevir or telaprevir with peginterferon and ribavirin (triple). Methods: Retrospective cohort study using data from Kaiser Permanente Southern California including participants ≥ 18 years old with a diagnosis and/or positive lab result for HCV RNA and ≥ 6 months continuous membership plus drug benefit prior to HCV treatment. HC utilization was determined 6 months prior to treatment and during treatment using an
Journal of Hepatology 2014 vol. 60 | S215–S359
S329
POSTERS electronic algorithm tabulating emails, telephone encounters, hospitalizations, emergency (ED) and office visits, labs, and new prescriptions. HC utilization for dual vs. triple therapy was compared. Results: From Jan 2002 through Dec 2012, 44,442 HCV patients were identified. After applying inclusion criteria, 6,759 treatment courses were identified in 6,341 patients. 6,355 treatment courses were dual and 404 were triple (172 boceprevir/232 telaprevir). 5,810 dual and 269 triple courses were in treatment-naive patients. A significant increase in pre-treatment outpatient visits was seen for triple vs dual therapy (9.01±5.56 vs 6.78±5.37, p ≤ 0.001). During treatment, triple therapy was associated with significantly greater HC utilization than dual therapy. Email encounters were also 2–3 times higher in triple vs dual therapy (Table 1). Table 1. Resource utilization during antiviral therapy Average utilization (per person)
ER count Pre-treatment Days 0–89 Days 90–179 Hospitalization Pre-treatment Days 0–89 Days 90–179 Outpatient visits Pre-treatment Days 0–89 Days 90–179 Lab tests Pre-treatment Days 0–89 Days 90–179 Prescription drugs Pre-treatment Days 0–89 Days 90–179 Average e-mail encounters Pre-treatment Days 0–89 90–179
Dual therapy
Triple therapy With BOC
With TVR
0.19 0.15 0.12
0.17 0.11 0.16
0.19 0.28 0.15
0.05 0.02 0.02
0.04 0.01 0.01
0.03 0.02 0.03
6.78 4.56 3.79
9.12 6.91 5.12
8.22 5.67 4.60
77.61 115.37 96.39
63.72 130.79 119.83
64.61 152.04 120.35
7.48 11.79 10.24
7.10 14.69 11.94
7.22 14.78 8.91
0.09 0.28 0.27
0.22 1.03 0.80
0.24 0.65 0.64
Conclusions: Health care resource utilization was significantly increased with triple vs dual therapy. Future treatment may require less HC resources due to expected shorter treatment duration and better side effect profiles. P779 PLATELET COUNT/SPLEEN DIAMETER RATIO (PSR) AS A PREDICTOR OF LIVER RELATED DECOMPENSATION IN PATIENTS WITH CHRONIC HEPATITIS C (CHC) AND LOW PLATELET COUNT F. Fernandes, G. Pereira, Z. Veiga, D. Martins, A. Campos, J.C. Lino, J.L. Pereira. Gastroenterology and Hepatology Unit, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil E-mail: ffernandes.fl[email protected] Background and Aims: PSR is a simple, non-invasive index, proposed to evaluate the presence of esophageal varices (EV). Our aim was to evaluate the PSR as a predictor of liver related decompensation in CHC outpatients. Methods: 76 CHC patients with platelets below 150.000 were submitted to upper endoscopy, abdominal sonography and blood evaluation. During a follow-up of 2 years, incidence of decompensations was registered and associated factors evaluated with the Cox Model. Results: Mean age was 57±11 years and 53% were females. Mean spleen size, platelets and PSR was 119±23 mm, 110±34×109 /L and 956±383, respectively. Mean bilirubin, albumin, INR and MELD S330
were: 1.2±0.6 mg/dL, 4.4±0.5 g/dL, 1.1±0.1 and 9±2, respectively. Most patients were Child A (95%) and 34% had EV. After two years, 11 patients had decompensated (ascites, hepatic encephalopathy and variceal bleeding in 6, 3 and 2, respectively). There were 3 deaths. On univariate analysis PSR, albumin and EV predicted decompensations (p value 0.020, 0.080 e 0.009, respectively). On multivariate analysis PSR below 1000 was the only independent predictor (HR 9.0 IC95% 1.1–7.1, p 0.037). The best cut-off points for PSR and albumin were 1000 (HR 8.6 (IC 95% 1.1–1.68)) and 4.4 (HR 4.8 (IC 95% 1.2–18.6)), respectively. Probability of decompensations with PSR higher or lower than 1000 was, respectively, 97 and 77% (p 0.013). Conclusions: CHC patients with thrombocytopenia have a high prevalence of EV and are very prone to decompensate. Amongst then, PSR can identify no invasively a subgroup of patients with high probability of developing liver related complications. P780 TRENDS IN THE SEROPREVALENCE OF HBV, HCV AND HIV INFECTION AT A REFERENCE MEDICAL AREA IN SPAIN OVER THE LAST FIVE YEARS 2 ´ Mena De Cea1 , L. Moldes Suarez2 , M. Perez-Abeledo ´ , I. Torres A. 2 3 2 Beceiro , H. Meijide , A. Canizares ˜ Catellanos , A. Castro-Iglesias1 , 2 1 1 J.D. Pedreira Andrade1 , G. Bou Arevalo ´ , E. Poveda Lopez ´ . Division of Clinical Virology, INIBIC-Complexo Hospitalario Universitario de A Coru˜ na, 2 Service of Microbiology, INIBIC-Complejo Hospitalario Universitario de A Coru˜ na, 3 Service of Internal Medicine, Hospital Quiron, Coru˜ na A, Spain E-mail: [email protected] Background and Aims: The seroprevalence of HBV, HCV and HIV in individuals attending a reference medical area in Spain during the last 5 years have been assessed. Methods: HBV, HCV and HIV serological markers were recorded at our reference lab ordered from primary care and specialized physicians between 2008–2012. Demographic and laboratory parameters were documented. Results: 131,544 HBsAg results were generated within the last 5 years, HBsAg prevalence was 1.6% remaining stable: 1.6% (2008), 1.7% (2009), 1.6% (2010), 1.6% (2011), and 1.5% (2012). HBsAg+ individuals were mostly (61.5%) male, mean age 45±17 years and 12.5% HBeAg+. From 92,143 anti-HCV-Ab results from this period, anti-HCV+ rate was 8.6% remaining stable: 8.2% (2008), 7.4% (2009), 7.8% (2010), 8% (2011), and 10.1% (2012). Conversely to USA data (highest rates of anti-HCV+ in persons born between 1945–1965), the highest rates of anti-HCV-Ab+ were observed between 1960–1975. Anti-HCV-Ab+ individuals were male (51.7%), mean age 45±18 years, and 56.3% viremic. HCV genotype distribution was: 59.7% G1, 5.4% G2, 22.7% G3, and 12.2% G4. From 65,279 anti-HIV-Ab results generated in this period, the antiHIV+ rate was 1.1% remaining stable: 1.1% (2008), 1.3% (2009), 1.4% (2010), 0.8% (2011), 1% (2012). The highest rates of anti-HIV+ were found for persons born between 1960–1975, similarly to that found for anti-HCV+. Conclusions: A relatively high prevalence of HBsAg, anti-HCV+, and anti-HIV+ (1.6%, 8.6%, and 1.1%, respectively) was observed in persons requiring medical care in Northern Spain. Conversely to USA data, highest rates of HCV exposure were observed in subjects born between 1960–1975.
Journal of Hepatology 2014 vol. 60 | S215–S359