CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

of developing LRE and with improved survival ( Hepatology 2003;37:902-908 ). We assessed the effect of sustained viral response (SVR) after pegylated interferon plus ribavirin (PR) on HVPG in HIV/HCV+ patients with CR. Methods: We reviewed the records of the portal hemodynamic laboratory of our institution to identify all HIV/HCV+ patients with CR who had a determination of HVPG before and after PR therapy between 2007 and 2012. Results: HVPG was determined in 60 HIV/HCV+ patients with CR. A total of 27/60 patients were treated with PR, and 15/27 treated patients achieved SVR. Consent to perform a 2 nd HVPG determination was given by 8/15 patients with SVR. In these 8 patients, the 2 nd HVPG determination was performed a median time of 18 (10 – 26) months after the discontinuation of PR. The median (IQR) HVPG was 15.5 (11.3-17.6) mmHg at baseline, and 8.8 (6.3-12.00) mmHg following SVR; P=0.01. After SVR, 7/8 patients experienced a decrease in HVPG ≥ 20% and all 7 had HVPG ≤ 12 mm Hg. In one patient with SVR, HVPG decreased 10%with a last value of 13.3 mmHg. After a median follow-up time of 60 months, all 8 patients were alive and free from LRE. Figure 1 shows median and IQR values and individual values of HVPG at baseline and after SVR.

Median and interquartile range (IQR) values, and individual values of hepatic venous pressure gradient (HVPG) at baseline and after sustained viral response (SVR). Conclusions: Our results suggest that eradication of HCV is associated with a marked and clinically significant reduction of HVPG in most HIV/HCV+ patients with CR and PH. However, some patients with CR and portal hypertension may remain at risk for LRE despite eradication of HCV.

TUESDAY, FEBRUARY 24, 2015 Session P-N4 Poster Session 2:30 pm– 4:00 pm HCV: Getting the Drugs to ThoseWho Need Them

Poster Hall

658 Assessment of PCP Knowledge of HCV Screening, Recommendations, and Treatment Options Allison Brodsky ; Monique Allen; Gregory Johnson; Lora Magaldi; Carolyn Moy; NancyTursi; StephanieTzarnas; StaceyTrooskin Drexel University College of Medicine, Philadelphia, PA, US

Poster Abstracts

Background: According to the CDC 50-75% of those chronically infected with HCV are unaware of their infection. Moreover, adults born between 1945-1965 have rates of HCV five times higher than other adults. CDC guidelines recommend that all baby-boomers be tested for HCV at least once in their lifetime. We aimed to assess primary care provider (PCP) knowledge of HCV screening guidelines and treatment options. We also assessed the accuracy of self-reported testing practices. Methods: A baseline survey to assess PCP and support staff knowledge about HCV testing, treatment, and guidelines was developed. Only practice-level identifiers were used, the survey was blinded with respect to individual identity. We administered the survey to PCPs at seven primary care practices in the Drexel Medicine network, including MDs and DOs, and to support staff including medical assistants and RNs. Self-reported testing practices were then compared to practice-level testing data extracted from the electronic medical record (EMR). Results: We surveyed 57 PCPs and 42 support staff . Thirty percent of PCPs and 11.9% of support staff surveyed knew that cure rates of HCV are >70% for patients who undergo treatment. Almost 40% of PCPs and 21% of support staff surveyed were aware that HCV can now be cured in 12-24 weeks. Sixty-eight percent of the PCPs, surveyed during May and June 2014, knew the CDC guidelines for birth cohort testing. In May, 6.9% of the 1658 baby-boomers seen in the primary care practices were screened for HCV. In June, 11.5% of the 1609 baby-boomers seen were screened for HCV. Conclusions: Less than half of the PCPs and support staff surveyed could accurately identify cure rates or treatment duration for HCV, indicating a lack of awareness of recent developments in HCV treatment options. Providers are aware of testing guidelines for baby-boomers, but are not routinely implementing them in their practice. Targeted education to PCPs and support staff regarding new HCV therapies should be provided. Education, however, may not be the only solution; additional tools to assist practices in integrating CDC testing recommendations into clinical workflow are needed. These may include prompts in the electronic medical record and involvement of support staff in the implementation of standardized testing/order placement protocols. 659 Majority of HCV/HIV-Infected Patients in the Netherlands Remain in Need of Effective HCV Treatment Colette Smit 1 ; Joop E. Arends 2 ; Marc van derValk 3 ; Kees Brinkman 4 ; Heidi Ammerlaan 5 ; S. Arend 6 ; Peter Reiss 1 ; Clemens Richter 7 1 Stichting HIV Monitoring, Amsterdam, Netherlands; 2 Universitair Medisch Centrum Utrecht, Utrecht, Netherlands; 3 Academic Medical Center, Amsterdam, Netherlands; 4 Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands; 5 CZE, Eindhoven, Netherlands; 6 Leiden University Medical Center, Leiden, Netherlands; 7 Rijnstate Ziekenhuis, Arnhem, Netherlands Background: A sustained virologic response (SVR) to HCV treatment is an important step in achieving optimal healthcare outcomes in HCV/HIV co-infected patients. To achieve a SVR, patients must be diagnosed with HCV, engaged in care, and prescribed treatment. The objective of this analysis is to describe the stages of the HCV cascade of care, including

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CROI 2015