V. de Ledinghen

Non-invasive tests for fibrosis and liver stiffness predict 5-year survival of patients chronically infected with hepatitis B virus.

Liver stiffness and non‐invasive tests predict overall survival in chronic hepatitis C. However, in patients chronically infected with hepatitis B virus (HBV), only the association between liver stiffness and the risk of hepatocellular carcinoma has been published.

The CUPIC algorithm: an accurate model for the prediction of sustained viral response under telaprevir or boceprevir triple therapy in cirrhotic patients

Triple therapy using boceprevir or telaprevir remains the reference treatment for genotype 1 chronic hepatitis C in countries where new interferon‐free regimens have not yet become available. Antiviral treatment is highly required in cirrhotic patients, but they represent a difficult‐to‐treat population. We aimed to develop a simple algorithm for the prediction of sustained viral response (SVR) in cirrhotic patients treated with triple therapy. A total of 484 cirrhotic patients from the ANRS CO20 CUPIC cohort treated with triple therapy were randomly distributed into derivation and validation sets. A total of 52.1% of patients achieved SVR. In the derivation set, a D0 score for the prediction of SVR before treatment initiation included the following independent predictors collected at day 0: prior treatment response, gamma‐GT, platelets, telaprevir treatment, viral load. To refine the prediction at the early phase of the treatment, a W4 score included as additional parameter the viral load collected at week 4. The D0 and W4 scores were combined in the CUPIC algorithm defining three subgroups: ‘no treatment initiation or early stop at week 4’, ‘undetermined’ and ‘SVR highly probable’. In the validation set, the rates of SVR in these three subgroups were, respectively, 11.1%, 50.0% and 82.2% (P < 0.001). By replacing the variable ‘prior treatment response’ with ‘IL28B genotype’, another algorithm was derived for treatment‐naïve patients with similar results. The CUPIC algorithm is an easy‐to‐use tool that helps physicians weigh their decision between immediately treating cirrhotic patients using boceprevir/telaprevir triple therapy or waiting for new drugs to become available in their country.

56 DYNAMICS OF HCV QUASISPECIES DURING TELAPREVIR TREATMENT DISSECTED USING ULTRA-DEEP PYROSEQUENCING: TREATMENT FAILURE IN 100% OF GENOTYPE 1A PATIENTS

56 DYNAMICS OF HCV QUASISPECIES DURING TELAPREVIR TREATMENT DISSECTED USING ULTRA-DEEP PYROSEQUENCING: TREATMENT FAILURE IN 100% OF GENOTYPE 1A PATIENTS P. Pinson, P. Trimoulet, J. Papuchon, J. Foucher, J. Vergniol, F. Chermak, L. Wittkop, W. Merrouche, S. Reigadas, M. Kann, H. Fleury, V. de Ledinghen. Laboratoire de Virologie et UMR 5234 CNRS, Service d’Hepato-Gastroenterologie, Hopital du Haut Leveque, CHU Bordeaux et Universite Bordeaux Segalen, INSERM U897, Institut de Sante Publique, Epidemiologie et Developpement (ISPED), Universite Bordeaux Segalen, Laboratoire de Microbiologie Fondamentale et Pathogenicite UMR5234, CHU Bordeaux et Universite Bordeaux Segalen, Bordeaux, France E-mail: patricia.recordon-pinson@u-bordeaux2.fr