AASLD Abstracts Tu1711 Clinical Trial of Rifaximin for Bacterial Translocation and Liver Stiffness in Hepatosplenic Schistosomiasis Edford Sinkala, Michael Vinikoor, Kanekwa Zyambo, Ellen Besa, Paul Kelly Background & Aims : Cirrhosis is the main cause of portal hypertension worldwide but schistosomiasis dominates in much of the tropics. The seroprevalence of Schistosoma mansoni is up to 77% in endemic parts of Zambia. Bacterial translocation (BT) is known to drive portal hypertension leading to variceal bleeding in cirrhosis but this is unexplored in hepatosplenic schistosomiasis (HSS). There are no data on liver stiffness in HSS. In a case control study, we recently demonstrated that HSS may be driven by inflammatory cytokines as a result of bacterial translocation from the GUT. We know that rifaximin is a minimally absorbable antibiotic which may reduce BT in patients with schistosomiasis related portal hypertension. We therefore set to demonstrate the effect of rifaximin on translocation, inflammatory and fibrotic markers. We also aim to evaluate liver stiffness in HSS using FibroScan. Methods: Of the 186 patients with HSS related oesophageal varices who were evaluated, 80 were recruited and 40 were randomised to rifaximin & standard care while 40 to standard care only. This was an open label clinical trial for 42 days. Patients were negative for human immunodeficiency virus (HIV), hepatitis B and C viruses. Plasma lipopolysaccharide binding protein (LBP) and 16SrRNA gene were used as markers of translocation while plasma hyaluronan, laminin and transient elastography were used to measure liver fibrosis. Tumour necrosis factor receptor 1 (TNF R1), soluble CD14(sCD14), soluble CD163 (sCD14) and interleukin 1 β (IL1β) were the inflammatory markers considered. Results: Median (interquar- tile range) FibroScan score was elevated in patients (9.95Kpa (7.75, 13.4)) compared to controls (4.0 (3.8, 4.2), p<0.0001). LBP, 16SrRNA, hyaluronan, laminin, IL1 β, sCD14, sCD163 and TNF R1 assays will be done at the end of clinical trial in early January, 2016. Conclusions: These data suggest that FibroScan score is abnormal in HSS and that it could be useful to discriminate from cirrhosis in patients with portal hypertension in HSS endemic areas. We await the trial results to evaluate translocation, inflammatory and fibrotic markers in HSS. Tu1714 Glycogenic Hepatopathy in Young Adults: Clinical Features, Diagnosis and Outcome Marco Silva, Armando Peixoto, Patrícia Andrade, Margarida Marques, Helder Cardoso, Guilherme Macedo BACKGROUND: Glycogenic Hepatopathy (GH) is a rare and underecognized complication of type 1 diabetes mellitus (DM) patients, which is characterized by the combination of poor glycemic control, acute liver injury with marked elevation in serum aminotransferases, and the characteristic histological features on liver biopsy. AIM: The authors propose to evaluate the demographics, etiology, clinical manifestations and prognosis of GH, highlighting the challenges in the differential diagnosis of hepatitis in young adults. METHODS: Retro- spective observational study of adult patients with GH, admitted between 2011 and 2014, in the gastroenterology department of a tertiary center. Data collection was performed from medical and laboratory records. All rules of local ethics committee were followed, preserving patient identity and confidentiality. RESULTS: In this study, 4 patients were identified, 1 man and 3 women, with a median age of 22 years. All patients had type 1 DM diagnosed in childhood (median duration of 17 years) and a history of poor glycemic control. Patients were admitted for uncontrolled DM [median HbA1c of 10.5% (4-6)] and for study of hepatomegaly and elevated liver enzymes [median: aspartate aminotransferase (AST) = 248U/ L (10-37); alanine aminotransferase (ALT) = 272U/L (10-37); gamma-glutamyl transpeptidase (GGT) = 112U/L (10-49); alkaline phosphatase (ALP)= 176U/L (30-120)], without elevated bilirubin. One patient presented with ascitis and other with elevated pancreatic enzymes. A thorough etiologic study was performed including liver biopsy in all cases, which confirmed the diagnosis of GH. During hospitalization, after adequate glycemic control with insulin therapy and adherence to a correct nutritional scheme, there was clinical improvement with progressive normalization of liver biochemical tests in all cases. CONCLUSIONS: Acute hepatitis in young adults and in type 1 DM is a clinical challenge and liver biopsy may be essential in many cases. It is very important to be aware of this pathologic condition because, when suspected and diagnosed, GH has a simple and effective treatment with an impact on the prognosis, as seen in our patients. Clinical awareness of GH should prevent diagnostic delay or misdiagnosis and will provide better insight and management for this condition. S-1170 AASLD Abstracts Tu1715 Disconnect Between Anti-Depressant Medication Prescription and Depressive Symptomatology in Chronic Hepatitis C Patients During Treatment Ali A. Weinstein, Carey Escheik, Phan H. Giang, Bibiana Oe, Zareen Arsalla, Aradhika Shrestha, Lynn Gerber, Zobair M. Younossi Background and Aim: Depressive symptomatology is frequently associated with chronic hepatitis C (HCV) infection and its treatment. Management of depressive symptoms during HCV treatment has not been well investigated, but is essential to determine since these symptoms can affect adherence to treatment, health-related quality of life (HRQL). We evaluated the relationship between the time trajectory of depressive symptoms and prescrip- tion of anti-depressant medication (ADM) in patients with HCV treated with pegylated interferon (PEG-IFN) and Ribavirin (RBV) combination. While this treatment regimen is no longer commonly used in the U.S., depressive symptoms are frequently observed, and remain important to manage. Methods: We included subjects who received an average of 24 weeks of weight-based dosing of RBV and the standard doses of PEG-IFN. Gender, age, marital status, history of substance abuse and depression, hemoglobin, aspartate amino transferase (AST), alanine aminotransferase (ALT), use of ADM, and depressive symptoms (Center for Epidemiologic Studies Depression Scale-CES-D) were determined prior to treatment and throughout the full length of the clinical trials. A linear regression was conducted to predict CES-D from the extracted variables and the longitudinal relationship between depressive symptomatology and ADM. Results: 67 patients were included (mean age: 47±7; 63% male; 10% receiving ADM prior to beginning treatment; mean AST/ALT: 0.80±0.6). The entire model predicted 36% of the variance in CES-D score (p<0.001). Two variables were statisti- cally significant predictors of higher future CES-D scores (more depressive symptoms): high CES-D score at the previous visit and prescription of ADM. None of the other extracted variables explained a significant portion of variance in CES-D scores. As seen in the Figure, the time trajectory of depressive symptomatology was not related to the percentage of patients who were prescribed ADM. Conclusions: These analyses point to the ineffectiveness of ADM prescription for reducing depressive symptoms as determined by CES-D scores during these clinical trials. Because the data showed a relative disconnect between ADM use and depressive symptomatology, explanations for this finding are needed. They include: 1. the possible time delay of effectiveness of medication, 2. The fact that CES-D scores reflect both cognitive-affective and somatic symptoms, and in this drug trial the latter may be significant and not respond to ADM and 3. Depressive symptoms may require medication combined with counseling or other therapeutic interventions. This finding should be investigated in trials using IFN-free and RBV-free treatment regimens. Tu1716 Quality of Life and Pediatric End-Stage Liver Disease Scores of Pediatric Liver Transplant Recipients in an Outpatient Clinic: A Cross-Sectional Study Maria C. Witkowski, Márcia K. Breigeiron, Sandra Maria G. Vieira, Carlos O. Kieling, Janete T. Oliveira, Marina R. Adami, Luma M. Ruschel Background: Liver transplantation is used to treat irreversible liver injury. The Pediatric End-Stage Liver Disease (PELD) prognostic score, which uses objective measures of clinical severity to prioritize organ allocation, is used to include children on liver transplant waiting lists. One of the main concerns of healthcare professionals involved in the care of these children is patient quality of life (QOL). Several instruments have been developed for QOL assessment; in pediatrics, the Pictured Child's Quality of Life Self Questionnaire (AUQUEI) stands out. The present study sought to assess QOL in pediatric liver transplant recipients receiving outpatient follow-up and its association with pre-transplant clinical severity. Meth- ods: This cross-sectional, prospective, quantitative study was conducted at the outpatient pediatric liver transplantation (PLTx) clinic of a university hospital in Southern Brazil between April and October 2014. Children were eligible if they had undergone PLTx (status > 30 days post transplantation), had learned or were learning to read and write, and were aged ≤ 12 years. Clinical and sociodemographic data on the children and their families were collected, and the AUQUEI was administered as a self-report questionnaire; an investigator assisted the child if requested. Results: The sample comprised 22 children with a mean (SD) age of 8 (2) years. The underlying diagnosis was biliary atresia in 19 cases (86.4%), and each child had a mean of 3 (1.4) prior hospitalizations. The median PELD score was 12.5 (range, -5 to +57) points. Regarding AUQUEI responses, the mean score obtained was 10 (2.5) points for the Function domain, 10 (2.5) points for the Family domain, 7.8 (1.5) points for the Leisure domain, and 7.6 (2.3) points for the Autonomy domain. The mean total score was 52 (7.7) points. Overall, 17 children (77.27%) had an AUQUEI score denoting positive quality of life. Analysis of correlation between PELD score and total AUQUEI score demonstrated that, the greater the clinical severity before transplantation, the higher the child's QOL after the procedure. Conclusions: Children followed as outpatients with a longer post-transplant time have a higher average QOL score.