894 IL28B-BASED MODEL FOR PREDICTION OF WEEK 4 VIRAL RESPONSE IN PEGINTERFERON-alfa2a + RIBAVIRIN TREATED HEPATITIS C GENOTYPE 1&4. FINAL REPORT WEEK 4 OPTIM STUDY

weeks of P+R therapy seems to be crucial to correctly classify patients according to interferon sensitivity: patients showing low sensitivity to IFN (decline <1Log HCV-RNA at week 4) and high chance of achieving SVR (when HCV-RNA was negative at week 4).Patients and Methods: Prospective and observational study including naïve patients aged ≥18, CHC genotype 1&4; excluding other liver diseases.Patients were treated with peginterferon-alfa 2a plus ribavirin.This analysis shows the differences between both populations in terms of baseline characteristics and first 4 weeks virological responses.Results: Seven-hundred and twenty-four patients were analyzed prospectively: 538 monoinfected/186 coinfected.Baseline characteristics coinfected vs. monoinfected: Coinfected were younger [44.6 (6) vs. 46.4(9.6) p < 0.005]; Mainly males [(79%) vs. (62%) p < 0.001]; Lower BMI [24.3 (4.0) vs. 26.6 (4.4) p < 0.001]; Showed more often significant fibrosis (Forns >4.2 or FIB4 >1.45) [(54.5%) vs. (41.6%)p < 0. 005]; HVL (>800.000UI/ml) [(66.1) vs. (56.6%)p < 0.05]; Infected more often by genotype 4 [(30.6%)vs. (15%) p < 0.001]; Higher AST/ALT ratio [(0.9) vs. (0.8) p < 0.001]; Higher GGT levels [(160) vs. (89) p < 0.001]; No differences were seen according to IL28B-CC [(36.2%) vs. (38.2%)p = 0.78].Response at week 4 coinfected vs monoinfected: RVR: [(10%) vs. (26.8%)p < 0.001].Decline ≥1Log HCV RNA at week 4: [(70.2%) vs. (83.7%)p < 0.001].Conclusions: Patients HIV-coinfected represent a population more difficult to treat than monoinfected ones.Although coinfected patients are more often infected by genotype 4, younger and lower BMI, an increased prevalence of advanced fibrosis, higher baseline HCV viral load and higher AST/ALT ratio, precluded better early virological response.The RVR and decline ≥1 Log HCV-RNA at week 4 are less common in coinfected patients.Therefore, it is of particular interest to have as soon as possible combined treatments with the new DAA in order to improve response rates in HIVcoinfected population.