73 A MULTICENTER ANALYSIS OF ANTIVIRAL RESPONSE AFTER ONE YEAR OF TENOFOVIR MONO-THERAPY IN HBV-MONOINFECTED PATIENTS WITH PRIOR NUCLEOS(T)IDE ANALOG EXPERIENCE

based format that includes discussion of history, physical examination and test results. In these case-based learning clinics, partners rapidly gain deep domain expertise in HCV as they collaborate with university specialists in hepatology, psychiatry and substance abuse in co-managing their patients. Results: Since June of 2003, 185 HCV knowledge network clinics have been conducted with 2640 case presentations of HCV patients. Of 327 patients treated via Project ECHO, 63.5% were members of a minority (Hispanic in 53.2%, Native American in 4.4%, and African American in 2.0%). Cirrhosis was present in 24.1% and depression in 41.4%. Genotype 1 was found in 61.1%, while the average log viral load was 5.94 ± 0.94. Early Virological Response was seen in 82/96 (85%), 61/74 (82%) and 105/ 113 (93%) of university, prison and rural patients. Significant adverse events (SAE) occurred in 24 (11.8%). Compared to patients without SAE, those with events were significantly older (48.7 ± 6.9 vs 43.6 ± 9.3 years; P=0.002); had lower serum albumin (3.69 ± 0.58 vs 4.08 ± 0.49 gm/dl; P=0.009), and platelet count (156 ± 75 vs 190 ± 81 x1000; P=0.047); and more likely to have cirrhosis of liver (50.0% vs 21.0%; P=0.002), and report a history of depression (66.7% vs 38.1%; P=0.008). Logistic regression showed that cirrhosis of liver [adjusted odds ratio (OR) 4.59; 95% confidence interval (CI) 1.66 12.7), depression (OR 4.77; 95% CI 1.66 13.7), were independent determinants of SAE (Hosmer-Lemeshow P= 0.927; ROC area 0.742). No differences in genotype distribution, SAE or response to treatment were found across sites. Conclusions: HCV treatment delivered to patients in rural areas and prisons using the Project ECHO model is as safe and effective as a university HCV clinic.