The sections were then colored by 3,3′-diaminobenzidine-tetrachloride as a substrate of peroxidase. Counter staining was performed by hematoxylin. Number and distribution of IgM positive cells were assessed using microscopy. Serum IgM data was expressed as mean ± standard error of the mean. Data between different groups were compared using the non-parametric Mann–Whitney U-test or Fisher’s exact test. All analyses were two-tailed P-values of less than 0.05 were considered statistically significant.

IMMUNOHISTOCHEMICALLY STAINED SERIAL sections of splenic tissues demonstrated that IgM positive cells were mainly distributed to the CD21 negative region nearby PALS (Fig. 1a,b) in positive cases. In PBC, IgM positive cells were accumulated in the CD21 positive lymph follicle in five PBC cases (63%) (Fig. 1c,d). CXCL13 positive beta-catenin inhibitor cells were especially detected in the center of the lymph follicle where IgM positive cells accumulated in PBC (Fig. 1e). IgM positive selleck chemicals llc cells were not observed in chronic HCV infection (Fig. 1f). There was a statistical significance (P = 0.02) compared to PBC. In PBC cases which had IgM

positive cells observed in the spleen had relatively higher serum IgM (310.6 ± 119.9 vs 241.3 ± 39.6 mg/dL) but were not statistically significant (Table 1). As extrasplenic study, liver biopsy samples from PBC patients were stained for IgM and CXCL13 similarly. IgM positive cells surrounding the intrahepatic bile duct were observed

in one out of 10 cases of PBC. Interestingly, in IgM positive liver, CXCL13 was also positively stained at the bile duct (Fig. 2). SPLENIC WHITE PULP consists of PALS and lymph follicles and is surrounded by the marginal zone. CD21 staining is useful to identify the FDC network in lymph follicles for histopathological analysis of the spleen. Because accumulation of IgM positive cells was observed Methocarbamol in the CD21 positive lymph follicle in splenic tissues collected from the PBC patients, it was suggested that IgM memory B cells proliferate and overproduce IgM in the spleen in PBC. We previously reported that Toll-like receptor (TLR)9 ligand CpG stimulates IgM memory B cells in the PBMC of PBC to produce an excessive amount of IgM.[3] It was also reported that TLR signaling stimulates generation of IgM memory B cells,[10] suggesting that circulating PAMP stimulate proliferation of the IgM memory B cells and IgM overproduction in the spleen. Such stimulation could be mediated by CD4 positive T cells[12] and CXCL13.[13] The present study demonstrated that the central region of the IgM positive follicle involves many CXCL13 positive cells in spleen in PBC. CXCL13 is a chemotactic chemokine that specifically stimulates B cells and is expressed in FDC, suggesting that FDC could essentially participate in IgM production in PBC.

12 The assessment was based on published reports and information provided by the authors of included trials. Following

the implications of empirical evidence,12–14 the methodological quality of the trials was assessed based on sequence generation allocation concealment, blinding of outcome assessors, incomplete outcome data (lost to follow-up and adherence to intention-to-treat analysis), and early stopping for benefit. The analyses were performed using Review Manager 5.0 and Trial Sequential Analysis version 0.8. Dichotomous data were expressed as the risk ratio (RR) with 95% confidence interval (CI). Furthermore, the number needed to treat was derived from the RR in meta-analyses where MI-503 price the 95% CI (or the RR) did not include zero. Heterogeneity was explored using a chi-square test, and the quantity of heterogeneity

was measured using the I2 statistic.15 Sources of heterogeneity were assessed with subgroup analysis and meta-regression whenever possible. Subgroup analyses were performed only when data from at least two trials were available for each subgroup. Meta-regression was performed only for meta-analyses including more than 10 trials. Suitable sensitivity analysis was identified during the review process. When patients were lost to follow-up, data were analyzed according to the intention-to-treat principle. Intention-to-treat learn more analysis was performed assuming poor outcome in both groups, where dropouts were considered failures and the total number

of patients was used as the denominator. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach16 to present the summary of findings for the patient important outcomes. To assess the reliability of pooled inferences from our meta-analysis on SVR, we calculated the optimum information size (OIS)—that is, the required meta-analysis sample size—to detect a 10% relative risk reduction in SVR, assuming an average event rate of 50% in the two treatment arms, assuming that 30% of the variation in the meta-analysis would be explained by variation across trials, and using statistical error levels of alpha = 5% and beta = 10% (90% power). www.selleck.co.jp/products/AG-014699.html Meta-analyses conducted before surpassing their OIS are analogous to interim analyses in single RCTs, and thus necessitate adjustment of the threshold for statistical significance to maintain the predetermined maximum risk of obtaining a false positive results (set to alpha 5% in our analysis). We therefore substituted the conventional 5% threshold for statistical significance with those of Lan-DeMets alpha-spending monitoring boundaries.8, 17–19 Figure 1 shows the results of the study screening. Twelve trials, including a total number of 5,008 participants,3, 20–30 that met our inclusion criteria31 were retrieved.

The cause of death from EPZ-6438 molecular weight the toxic liver injury was not characterized, correction of any specific liver function by the engrafted

cells was not demonstrated, and whether the iPSC-derived hepatocytes responded appropriately to proliferation signals after loss of hepatocyte mass was not tested. In summary, the recent findings by Takebe et al. offer encouragement for the use of PSC-derived hepatocytes for tissue engineering. Nevertheless, it is important to recognize that a combination of vasculature, stromal cells, and hepatocytes does not an organ make. Liver architecture, including biliary structures, is critical for the liver’s exocrine function. Liver-like tissues have been generated from primary rodent and human hepatocytes,[11, 12] and primary hepatocytes that have colonized

lymph nodes can produce enough ectopic liver mass to rescue a mouse from a lethal metabolic disease, indicating that the lymph node contains enough structure for primary Fulvestrant mouse cells to support liver tissue and life-sustaining organ function. It may also be important to consider that nonparenchymal cells could have organ-specific characteristics that potentially have unique roles in controlling organ development and function.[14] Transplant of iPSC-derived liver buds into the native hepatic environment may therefore prove to be efficacious and could potentially promote cholangiocyte differentiation. The potential to generate organs from iPSCs is exciting and could have substantial ramification for the treatment of liver disease; however, more complete differentiation

of iPSCs to a mature hepatic phenotype with the capacity to expand as robustly as primary human hepatocytes will be required. Long-term engraftment in host animals has long been thought to be the most likely way to produce near-complete maturation of iPSC-derived hepatocytes. A significant finding from this study is that, unlike iPSC-derived pancreatic beta cells, the iPSC-derived hepatocytes in the cell clusters failed to completely differentiate after transplantation in immune-deficient adult hosts.[13] Thus, many important positive and negative lessons can be taken from this work, and, with them, many more questions will need answers. The authors thank Dr. Jayanta Roy-Chowdhury for his Digestive enzyme careful review of the manuscript and helpful suggestions. Ira J. Fox, M.D.1 “
“Background and Aim:  A number of hepatitis C virus (HCV) patients without a rapid virological response (RVR) achieved a sustained virological response (SVR) with peginterferon-α-2a/ribavirin. The aim of this study was to identify factors associated with SVR in non-RVR patients. Methods:  Baseline and on-treatment factors were used to explore the prognostic factors for SVR in 113 HCV genotype-1 (HCV-1) and 20 HCV-2 non-RVR patients in two randomized trials.

Methods: Adult patients enrolled in one of the NASH CRN studies with 2 or more biopsies (excluding active treatment arms of the PIVENS study) at least a year apart were included. Laboratory and anthropometric data was included if available within 6 months of biopsy. All biopsies underwent blinded consensus review. Fibrosis progression/regression was defined as any worsening/improvement in fibrosis stage. Univariate and multivariate logistic regression models were used to assess association with fibrosis progression. Results: 359 patients (mean age 47 years,

64% female) had at least 2 biopsies, with a mean time between biopsies of 4.4 years (range 1 to 17.3).128 showed fibrosis progression and 103 showed regression.181 patients had laboratory data available Atezolizumab at baseline. Using any degree of fibrosis progression as the outcome, only ballooning (O. R.0.67), Mallory-Denk bodies (O. R.2.4), and Caucasian race (O. R.3.4) showed significant associations (p<0.05) in multivariate models. We therefore examined the changes in laboratory data and BMI from first to last biopsy (Table) adjusting for baseline values in 169 patients with paired clinical data. While changes in BMI and transaminases were significant in the univariate model, only worsening transaminase levels were associated with fibrosis progression in the multivariate model. Conclusion: The natural history of NAFLD is complex, with both improvement and worsening observed in

a mean four year interval. Baseline histologic, demographic, anthropometric and laboratory

Selleckchem Doramapimod data were of little value in predicting fibrosis progression, but increased transaminases and BMI from first to last biopsy were associated with fibrosis progression. Univariate Multivariate Characteristic O. R. 95% CI P O. R. 95% CI P A BMI (kg/m2) 1.19 1.03-1.36 0.02 1.14 0.97-1.34 0.11 AALT(U/L/10) 1.18 1.05-1.33 0.004 1.20 1.04-1.38 0.01 A AST (U/L/10) 1.35 1.14-1.59 <0.001 A Aik phos (U/L/10) 1.17 0.98-1.40 0.08 1.09 0.89-1.33 0.43 A Triglycerides (mg/dL/10) 1.01 0.99-1.04 0.38 1.01 0.99-1.04 0.27 A Glucose (mg/dL/10) 1.08 0.98-1.18 0.10 A Insulin Aurora Kinase (μU/mL/10) 1.04 0.91-1.19 0.54 A HOMA-IR (log) 1.02 0.98-1.06 0.36 1.00 0.96-1.05 0.86 Disclosures: Elizabeth M. Brunt – Speaking and Teaching: Geneva Foundation Kris V. Kowdley – Advisory Committees or Review Panels: Abbott, Gilead, Merck, Novartis, Vertex; Grant/Research Support: Abbott, Beckman, Boeringer Ingelheim, BMS, Gilead Sciences, Ikaria, Janssen, Merck, Mochida, Vertex Arun J. Sanyal – Advisory Committees or Review Panels: Gore, Gilead, Abbott, Ikaria; Consulting: Salix, Immuron, Exhalenz, Bayer-Onyx, Genentech, Norgine, GalMed, Novartis, Echosens, Takeda; Grant/Research Support: Salix, Genentech, Genfit, Intercept, Ikaria, Takeda, Gilead; Independent Contractor: UpToDate Brent A. Neuschwander-Tetri – Advisory Committees or Review Panels: Genentech, Nimbus Discovery The following people have nothing to disclose: David E.

The DWPG approach was compared to non-discretized (continuous) and other popular discretized approaches (Minimum Description Length Principle, MDLP and Entropy-based Discretization Osimertinib concentration According to Distribution of Boundary

Points, EDA-DB) in error rate, discretization time and classification time during the training process. Results: Of 500 ROIs, 250 were normal and 250 were atrophic gastritis. There were 60 extracted features including 24 textured-features and 36 colored-features. The error rate (mean ± standard deviation) for continuous, MDLP, EDA-DB and DWPG was 28.0 ± 1.8, 35.3 ± 1.2, 29.6 ± 1.9 and 27.3 ± 2.5 respectively. Discretization time for MDLP, EDA-DB and DWPG was 13.8 s, 16.7 s and 11.3 s respectively. The classification time for continuous, MDLP, EDA-DB and DWPG was 0.4 s, 0.3 s, 0.3 s and 0.3 s respectively. Conclusion: Compared to other discretization approaches, DWPG has Pifithrin-�� datasheet less error rate, less discretization time and comparable classification time. Improved classification, in future, may allow reliable and rapid endoscopic identification

of atrophic gastritis. Key Word(s): 1. endoscopic gastritis; 2. computer-aided; 3. discretization; 4. atrophic gastritis; Presenting Author: GORAN POROPAT Additional Authors: GORAN HAUSER, MARKO MILOSEVIC, NIKOLINA BENIC, DAVOR STIMAC Corresponding Author: GORAN POROPAT Affiliations: University Hospital Rijeka Objective: Post endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Causes of PEP are not completely established but there are several risk factors. The aim of this study was to investigate correlation between Selleckchem U0126 various diagnoses and occurrence of PEP. Methods: All patients with indication for ERCP at our tertiary care center

from January to December 2012 were included. All patients received diclophenac sodium suppositories immediately before procedure. We used Spearman correlation coefficient in order to detect possible significant correlation. Results: We included total number of 169 patients, 94 males (55%) and 75 females (45%), mean age was 70.58 ± 13.77 years. We observed PEP in 24 out of 169 patients (14%), 13 males (54.2%) and 11 females (45.8%). Mean duration of procedure was 45 ± 26.00 min. Among others, the most common reasons for ERCP were choledocholithiasis (57.6%) and pancreatic carcinoma (12.9%). We found significant correlation of PEP only with extrahepatic ducts neoplasms, r = 0.185, p < 0.05. There were no correlation among PEP and pancreatic carcinoma, choledocholithiasis, acute or chronic pancreatitis. Conclusion: Extrahepatic ducts malignancies are correlated with higher incidence of PEP possibly due to difficult cannulation and prolonged procedure. Key Word(s): 1. Biliary neoplasms; 2. ERCP; 3.

184 Ileal pouch-anal anastomosis also requires expertise FG-4592 mw and centralization of experience to fewer treatment centers can be recommended. Acute complications of

IPAA include anastomotic leak, sepsis, injury to local structures including pelvic nerves. Because fecundity can be impaired with IPAA in young female patients, ileorectal anastomosis should be considered. Also, in the elderly and females with delivery-related injury during childbirth, anal sphincter may be weakened and IPAA may be complicated by fecal incontinence. Pouchitis is a non-specific inflammation of the ileal reservoir and the most common complication of IPAA in patients with UC. Screening tests according to local practice for hepatitis B virus infection [III,A], human immunodeficiency virus [III,C], and TB [II-3,A] need to be considered prior to commencement of corticosteroids, immunomodulators and/or biologic agents. Vaccination, prophylaxis or therapy should be performed in appropriate clinical settings. [III,C] Level of agreement: a-19%, b-81%, c-0%, d-0%, e-0% Quality of evidence and Classification of recommendation: as above Hepatitis B virus infection.  The prevalence of hepatitis B virus (HBV) infection is higher in the Asia-Pacific region than Western countries. The withdrawal of immunosuppressive

EPZ-6438 order therapy can result in severe HBV reactivation thus preemptive treatment with a nucleoside or nucleotide analogue may suppress viral replication on initiation of immunosuppression. Case reports of HBV reactivation IMP dehydrogenase are described following the use of IFX, AZA/ 6-MP with or without corticosteroids and rarely results in fulminant hepatic failure.185,186 In the Asia-Pacific region, HBV serology should be performed in all IBD patients as HBV-negative and HBV surface-antibody negative patients can receive vaccination, and HBV surface antigen-positive patients can be treated with anti-viral agents prior to immunosuppression.

Hepatitis B virus anti-core-antibody-positive surface antigen-negative patients require close monitoring for possible HBV reactivation and hepatitis flare.187 Tuberculosis.  The prevalence of tuberculosis (TB) is high in many parts of the Asia-Pacific region. Intestinal TB is a differential diagnosis in newly diagnosed IBD. Screening for TB is mandatory in Asian countries and high-risk cases require anti-TB treatment or chemoprophylaxis with isoniazid according to acceptable local practice.117 Screening strategies differ according to endemic TB prevalence and BCG vaccination practice but can include chest radiograph, tuberculin skin testing, human mycobacterium-specific interferon gamma assays, and high vigilance in the development of breakthrough infection. Other opportunistic infections.

Examples include common and uncommon visual disturbances related to migraine, painful loss of vision, eye pain, photophobia, pupillary disorders, and

painful ophthalmoplegia. There are often articles relevant to headache specialists that are published in the ophthalmic literature. This commentary highlights 2 interesting clinical articles. All neurologists and headache medicine specialists should read the review on photophobia by Digre and Brennan as it is relevant, clinical, and comprehensive. The literature review on topiramate-related acute angle-closure glaucoma provides us with useful information about the epidemiology and pathophysiology of this rare but potentially vision-threatening condition that may occur with the most widely used of migraine preventives. “
“La obesidad es una epidemia presente en muchas personas que tanto padecen, como no padecen de migraña. ¿Cómo es que la obesidad y la migraña selleck screening library se relacionan? ¿Cuales son los factores de riesgo para las personas que padecen de migraña que están luchando con esas libras demás ? Primero, necesitamos definir la obesidad. La obesidad se define como un índice de masa corporal (IMC) de 30 o más. Se pueden encontrar calculadoras de IMC en el internet y en aplicaciones para teléfonos

inteligentes. Si deseas calcular el IMC, la fórmula es la siguiente: peso en libras/[(pulgadas de altura) x (pulgadas de altura)] x 703. La obesidad abdominal, término dado a la grasa acumulada Wnt inhibitor en el abdomen, está asociada a un riesgo mayor de enfermedad cardiovascular Phospholipase D1 y diabetes. Por esta razón, es más útil definir la obesidad en cuanto a obesidad abdominal y obesidad del cuerpo entero. La obesidad abdominal se define como la circunferencia de cintura de más de 40 pulgadas en hombres y más de 35 pulgadas en mujeres o como la proporción de cintura y cadera de más de 0.9 para hombres y más de 0.85 para mujeres. La migraña que ocurre más de 15 días al mes y por lo menos 4 horas por día se considera migraña crónica.

¿Por qué es que las personas que tienen migraña solamente algunos días al mes, a menudo, progresan lentamente a un patron de migraña crónica? Existen varias posibles razones que causan este aumento, algunas razones que se pueden modificar y otras que no. El uso frecuente de medicamentos para el dolor agudo es una razón común para la transformación a cefalea diaria. Otras posibles razones para transformación a migraña crónica son: exceso de cafeína, roncar o el apnea del sueño, desordenes de la tiroide, trauma a la cabeza, estresores, depresión, y ansiedad. Sin embargo, para propósito de este material educativo nos enfocaremos en la obesidad como un riesgo para la migraña crónica. Una persona de peso normal con migraña tiene un 3% de probabilidad al año en desarrollar cefaleas crónicas. Si la persona está en sobrepeso tiene 3 veces esa probabilidad.

Glia, and in particular astrocytes,

are vital in neuronal and CNS homeostasis. Increased expression of the astrocyte marker, glial fibrillary-associated protein (GFAP), implies neuroinflammation, linked with neuropathic pain and memory impairment. We determined whether 5-FU induced astrocyte activation via immune-to-CNS signaling pathways (neuronal vs humoral) and secondly, if astrocyte reactivity persisted beyond the intestinal injury. Materials and Methods: Female Dark Agouti rats (n = 8) were randomly allocated to saline control or 5-FU (i.p. 150 mg/kg) groups and tissues collected at either injury peak (day 3) or recovery (day 5). Western Blot analysis of hippocampal and thoracic sections determined GFAP and Interleukin-1

beta (IL-1β) expression. Myeloperoxidase (MPO) assay quantified intestinal inflammation. Statistical comparisons were conducted using GW 572016 a two-way ANOVA with Tukey’s post-hoc test. All data were expressed as mean ± SEM with p < 0.05 deemed statistically significant. Results: At injury peak (day 3), the bodyweight of 5-FU treated www.selleckchem.com/products/Methazolastone.html rats was 91% that of vehicle controls (p = 0.02) and MPO activity increased by 282% in the jejunum and 213% in the ileum compared to vehicle controls (p = 0.0007 and p = 0.0003, respectively). Although hippocampal GFAP expression showed little variance (p > 0.05), interestingly thoracic GFAP expression was significantly reduced by 28% in 5-FU treated rats compared to vehicle controls at injury peak of mucositis (day 5; p = 0.04),

yet normalized during the recovery phase (day 5; p > 0.05). IL-1β expression levels remained unchanged at both time-points. Conclusions: Down-regulation of thoracic GFAP expression is associated with astrocyte dysregulation in rats with 5-FU-induced mucositis; suggesting implications for CNS homeostasis and neuronal signaling. Further studies should clarify the role of glial dysregulation in 5-FU-induced mucositis and its potential implications Niclosamide in chemotherapy-related side-effects, such as cognitive impairment and cancer-induced pain. KE FARRELL, BA GRAHAM, S KEELY, RJ CALLISTER School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW and Hunter Medical Research Institute, New Lambton Heights, NSW Introduction: Chronic abdominal pain is a common and debilitating symptom of Inflammatory Bowel Disease (IBD). Interestingly, 30–50% of patients continue to experience pain despite clinical remission. Although the mechanisms responsible for the development of chronic pain in this subset of IBD patients are unknown, there is evidence from animal studies that central nervous system (CNS) plasticity is involved1.

A 68 year old fisherman presented with a two day history of severe epigastric pain. He also complained of fever and myalgia. He was transferred to a tertiary center for exclusion of a malignant gastric ulcer. He had not taken any anti-ulcer medication or nonsteroidal anti-inflammatory drugs (NSAID) prior to hospitalization. His vital signs were: blood pressure 120/80 mm Hg, pulse rate 80 beats per minute, respiration rate 20 breaths per minute, and body temperature 38.5°C. On physical examination, epigastric tenderness without rebound tenderness was observed, and an eschar was seen at the posterior neck. There was no other skin rash.

Investigations included a leukocyte count of 7640/µL, hemoglobin 12.8 g/dL, platelet count 189,000/µL, www.selleckchem.com/products/CAL-101.html blood urea nitrogen 17 mg/dL, serum creatinine 0.8 mg/dL, aspartate aminotransferase (AST) 162 IU/L, alanine aminotransferase (ALT) 172 IU/L, and total bilirubin 0.3 mg/dL. selleckchem Upper GI endoscopy revealed multiple irregular shaped ulcers and erosions with circumferential arrangement. (Figure 1) Multifocal hyperemic petechiaes in the duodenal bulb

were also present (Figure 2). Histopathologic findings showed diffuse infiltration of inflammatory cells without malignant cells. The immunofluorescent antibody test for O. tsutsugamushi was positive with a titer of 1:20,480, which confirmed the diagnosis of scrub typhus. The patient was treated with doxycycline 100 mg PO twice daily and pantoprazole 40mg PO once daily. One day after the commencement of medical therapy, the fever improved and the epigastric pain subsided. Although skin rash and eschar

are typical physical findings related to vasculitis resulting from scrub typhus infection, mucosal damage of the gastrointestinal tract may develop. The major endoscopic features include petechiae, superficial hemorrhage, erosions and ulceration with or without bleeding. Upper GI endoscopy should be considered for the early diagnosis and subsequent management of patients with severe GI symptoms, particularly if there is an eschar. Telomerase In addition to appropriate antibiotic therapy, antiulcer medications according to the severity of endoscopic findings may be very helpful to relieve the symptoms. Contributed by “
“Jay Donald Ostrow (Fig. 1) suddenly and unexpectedly passed away on January 9, 2013 at the age of 83. Don was born in New York, NY on January 1, 1930. Don obtained his BS in Chemistry at Yale in 1950 and his MD degree at Harvard 4 years later. He then went to the University College in London in 1969-1970 where he obtained the title of Magister Scientiae in Biochemistry in 1970 under the tutelage of Barbara Billing. His postgraduate training exposed him to the best of medical training, moving from Johns Hopkins to Harvard Medical School where he became chief research fellow in the laboratory directed by Rudi Schmid, one of the fathers of modern bilirubin science.

Resistance mutations to lamivudine and/or ETV was detected only in 3 and 2 patients Selleck CP690550 in the TDF and TDF+ETV groups, respectively, at 48 weeks. None developed additional resistance mutations. None in the TDF group required protocol-defined switch over of treatment. Both treatments were

well tolerated, and safety and adverse event profiles were similar in the two groups. Conclusions: TDF monotherapy showed similarly high antiviral efficacy and safety as TDF and ETV combination therapy during 48 weeks of treatment in patients with ETV-resistant HBV. None developed additional resistance mutations. KEY WORDS: Lami-vudine, Monotherapy, Resistance, Virologic response Disclosures: Young-Suk Lim – Advisory Committees or Review

Panels: Gilead Science, Bayer; Grant/Research Support: Gilead Science, Novartis, Bayer; Speaking and Teaching: BMS Kwan Soo Byun – Advisory Committees or Review Panels: Gilead; Grant/ Research Support: Gilead, BMS, Taiho, Jassen; Speaking and Teaching: BMS Han Chu Lee – Grant/Research Support: Medigen Biotechnology Co., Novartis, Roche, Bayer HealthCare, Bristol-Myers Squibb, INC research, Boehringer Ingel-heim, Taiho Pharmaceutical Buparlisib supplier Co., Yuhan Co. The following people have nothing to disclose: Geum-Youn Gwak, Byung Chul Yoo, So Young Kwon, Yoon Jun Kim, Jihyun An, Yung Sang Lee Background: Antiviral therapy may reduce HCC risk but it is unclear what the residual risk would be in treated patients. Our aim is to characterize Progesterone HCC incidence in treated and untreated patients by cirrhosis status, age (< 45 or ≥45), and gender. Methods: In this retrospective cohort study, 3933 consecutive CHB patients were identified at 3 US centers from 1991-2014. Patients were included if they had at least one year of follow-up and treatment-naïve. Exclusion criteria included HCC at initial presentation and the development of HCC within the first year of follow-up. Diagnosis was based on AASLD criteria for HCC and histology or clinical or imaging data for cirrhosis. Annual

incidence was calculated in cases per 1000 person years. Results: We included a total of 3220 patients with 102 incident HCC cases over a median time of follow-up of 4.1 (1-17) years. In multivariate analysis, antiviral therapy was an independent predictor for reduced HCC risk (HR 0.43, 95% CI 0.23-0.79) following adjustment for age, gender, cirrhosis, HBeAg, ALT, and HBV DNA. In cirrhotic men, regardless of age, the treated group had a lower incidence of HCC (Figure 1). For the non-cirrhotic cohort, the effects of antivirals, while beneficial were modest with the exception of men ≥45 years of age. HCC incidence in treated non-cirrhotic patients ranged from 0 to 1.2 cases per 1000 person years among the various age and gender groups compared to 0 to 6.4 per 1000 person years if untreated. HCC incidence in cirrhotic patients still ranged 16.