1074 INFLUENCE OF NICOTINE ABUSE ON FIBROSIS PROGRESSION IN CHRONIC HEPATITIS C VIRUS (HCV) INFECTION

PURPOSE: Data on HBV/HCV co-infection is limited as most studies are small, from Asia or Europe, and only compared to HCV patients. Our goal was to characterize HBV/HCV co-infected patients in a large multiethnic matched case-control study of co-infected and HBV-monoinfected patients at 2 large U.S. centers. METHODS: Using electronic query of ICD9 codes and chart review, we identified 115 HBV/HCV patients with serial HBVDNA, HCVRNA, and ALT results. 115 HBV monoinfected controls were chosen randomly and matched to cases by age±10 years, gender, Asian vs. non-Asian ethnicity, and study site. RESULTS: Both groups had similar gender, ethnic distribution, and mean age: 68% male, 83% Asian, and 52±14 years. Mean follow-up for both was between 57-62 months. More monoinfected patients received therapy for HBV than co-infected (43% vs. 23%, p<0.002). Co-infected patients exhibited very little HBV/HCV co-dominance at baseline and throughout follow up: patients had either HBV viremia with low/absent HCV viremia or HCV viremia with low/absent HBV viremia (Table 1). Compared to Asians, non-Asians had significantly higher rates of inactive disease for both viruses (25% vs. 14%) and HCV viral dominance (65% vs. 49%) (p=0.047). On multivariate analysis also inclusive of age and gender, Asian ethnicity was a significant predictor for HBV dominance at presentation (OR=6.8, p=0.047). CONCLUSION: HBV/HCV co-infected and HBV monoinfected patients generally had similar clinical characteristics. At presentation and long-term follow-up, either HBV or HCV dominates with little co-dominance. Absence of viremia and HCV-dominance are more common in non-Asians. Asian ethnicity is a major independent predictor for HBV-dominant disease. Larger studies are needed to further characterize the natural history of HBV/HCV co-infection in Asians and non-Asians.