sensitivity and specificity in detecting significant fibrosis with a cutoff of 13.5 kPa. THU-495 Predictive value of S-GGT for severe liver disease in the general population – a population-based cohort study with over a decade of follow-up F. Åberg 1 , J. Helenius-Hietala 2 , P. Puukka 3 , M. Färkkilä 4 , A. Jula 3 . 1 Transplantation and Liver Surgery Clinic; 2 Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki University, Helsinki; 3 Department of Health, National Institute for Health and Welfare, Turku; 4 Department of Gastroenterology, Helsinki University Hospital, Helsinki University, Helsinki, Finland E-mail: fredrik.aberg@helsinki.fi Background and Aims: Gamma-glutamyltransferase (GGT) is a marker of alcohol use and NAFLD, but the clinical value of GGT in predicting liver events at the population level remains unclear. Methods: S-GGT was measured in 6732 subjects without baseline liver disease who participated in the Finnish population-based Health 2000 Survey (2000–2001), a nationally representative cohort. Follow-up data until 2013 for liver-related admissions, mortality, and liver cancer came from national registers. Mean follow-up was 11.4 years (SD 3.3). The value of GGT in predicting liver events was assessed by the area under the curve (AUC) generated by receiver operator characteristics. Results: Of 6732 subjects, 756 (11%) were alcohol risk users (>210 g/ week for men, >140 g/week for women), and 3027 (45%) had metabolic syndrome (MetS). Accuracy of GGT in predicting severe liver events was good with the optimal GGT cutoff around 50 U/L (Table). Current UNL of GGT is 60 U/L for men and 40 U/L for women. Among subjects without alcohol risk use or MetS, the optimal cutoff was 26 U/L. Elevated GGT emerged as an independent predictor of serious liver events (HR 1.006, 95%CI 1.005–1.007, P < 0.001) in multivariate Cox-regression analysis adjusted for age, gender, average alcohol use (g/day), body-mass index and smoking status. AUC (95% CI) P Optimal GGT cutoff * Sensitivity Specificity PPV NPV All subjects 0.78 (0.73– 0.84) <0.001 50 0.65 0.84 5.3% 0.6% Alcohol +** 0.75 (0.66– 0.84) <0.001 54 0.79 0.65 9.3% 1.6% Alcohol - 0.76 (0.68– 0.83) <0.001 50 0.58 0.87 3.8% 0.4% MetS 0.78 (0.71– 0.85) <0.001 50 0.73 0.77 5.8% 0.7% No MetS 0.76 (0.66– 0.85) <0.001 41 0.59 0.85 3.4% 0.5% Neither alcohol nor MetS 0.75 (0.62– 0.88) <0.001 26 0.75 0.68 1.5% 0.6% *Youden index. **>210g/wk for men, >140g/wk for women. PPV, positive predictive value; NPV, negative predictive value. Conclusions: Nine percent of alcohol risk drinkers with a GGT value above 50U/L will develop serious liver disease over the next decade. Among non-risk drinkers, a GGT value below 50 U/L excludes such future liverevents with over 99% certainty regardless of MetS. GGT may help in the risk stratification of the general population with regards to future liver disease. The GT cutoff values should be taken into consideration when determining the upper normal values of GT. THU-496 Assessment of fibrosis markers in a large cohort of chronic hepatitis B patients in Ethiopia H. Desalegn 1 , H. Aberra 1 , N. Berhe 2 , S.G. Gundersen 3 , A. Johannessen 4 . 1 St. Paul Hospital Millennium Medical College; 2 Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 3 Research Unit, Sorlandet Hospital HF, Kristiansand; 4 Regional Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, Norway E-mail: johannessen.asgeir@gmail.com Background and Aims: In the absence of liver biopsy and transient elastography, the World Health Organization (WHO) recommends non-invasive tests, based on simple laboratory data, to assess liver fibrosis in patients with chronic hepatitis B (CHB). However, these tests are not well validated in sub-Saharan Africa. A recent study from West Africa suggested that a new marker, GPR (gamma-glutamyl transpeptidase to platelet ratio), performs better in an African setting, but this needs confirmation in other cohorts. The aim of this study was to evaluate the diagnostic performance of APRI (aspartate aminotransferase to platelet ratio index), FIB-4 and the novel marker GPR in one of the largest CHB cohorts in sub-Saharan Africa. Methods: A prospective cohort study was initiated at St. Paul’s Hospital Millennium Medical College in Ethiopia in 2015 in order to study CHB treatment in a low-income country. The baseline assessment included laboratory data and transient elastography (Fibroscan 402, Echosense, France). Non-invasive tests were com- pared with transient elastography using the following thresholds: no fibrosis (Metavir score F0-1; ≤7.9 kPa), significant fibrosis (F2-4; >7.9 kPa) and cirrhosis (F4; >11.7 kPa). Individuals with the following conditions were excluded from the present analysis: pregnancy, HIV co-infection, concomitant tuberculosis, self-reported alcohol con- sumption >20 g/day, ALTelevated more than 10 times the upper limit of normal, and prior or current CHB antiviral therapy. The diagnostic accuracy of non-invasive tests was estimated by calculating the area under the receiver operating characteristics curve (AUROC). Results: >A total of 582 treatment-naïve patients were included in the present analysis. Median age was 31 years (interquartile range [IQR] 27–39), 351 (60.3%) were males, and median transient elastography value was 5.8 kPa (IQR 4.6–7.7). One-hundred-and- forty-one (24.2%) patients had significant fibrosis and 90 (15.5%) had cirrhosis. The AUROC of APRI, FIB-4 and GPR was high both to diagnose significant fibrosis and cirrhosis (Table 1). GPR was not significantly better than the WHO recommended non-invasive tests. Table 1: Diagnostic performance of non-invasive markers to detect significant fibrosis (F2-4) and cirrhosis (F4) in Ethiopian patients with chronic hepatitis B F0-1 vs. F2–4 F0–3 vs. F4 GPR AUROC (95% CI) 0.80 (0.75–0.85) 0.87 (0.82–0.91) Cut-off values 0.32 0.56 Sensitivity/specificity 45/94 36/98 PPV/NPV 69/84 76/89 APRI AUROC (95 % CI) 0.79 (0.75–0.84) 0.86 (0.81–0.91) Cut-off values 0.5 1.5 1 2 Sens./Specificity 48/95 10/99 27/98 10/99 PPV/NPV 75/85 88/78 76/88 90/86 FIB-4 AUROC (95 % CI) 0.79 (0.75–0.84) 0.86 (0.81–0.91) Cut-off values 1.45 3.25 Sens./Specificity N/A N/A PPV/NPV N/A N/A GPR, gamma-glutamyl transpeptidase to platelet ratio; AUROC, area under the receiver operating characteristic curve; CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; APRI, aspartate aminotransferase to platelet ratio index; N/A, not applicable. POSTER PRESENTATIONS S241 Journal of Hepatology 2017 vol. 66 | S95–S332