Results: Portal angiomatosis was the most frequent microvascular change (46/74 cases; 62.1%), and it stronglycorrelated with the HAI ( p = 0.003), the stage of fibrosis ( p = 0.00), the extension of sinusoidal capillarization (i.e. CD34 expression) (p = 0.04), and with ASMA expression in both zone 1 ( p = 0.0005) and 2/3 (p = 0.03). Aberrant vessels were detected in 21.6% (16/74) of cases and correlated with the stage of fibrosis (p = 0.008) and with the extension of ASMA immunoreactivity in zones 2/3. Microvascular density in portal tracts was significantly related to the number of 8-OHdG adducts. At the multivariate analysis, portal angiomatosis was an independent predictor of fibrosis stage ( p = 0.02). Conclusions: Histological microvascular abnormalities are common in CHB and CHC. Their correlation with fibrosis stage, sinusoidal capillarization, neoangiogenesis, and ongoing fibrogenesis supports a role in disease progression. Systematic assessment of microvascular changes in liver biopsies of chronic viral hepatitis might provide prognostic informations. SAT-198 Adherence to prescriptions a better predictor than adherence to treatment visits for SVR among patients treated with DAA therapy in a task-shifting model S. Kattakuzhy 1 , B. Emmanuel 2 , C. Gross 1 , E. Rosenthal 1 , H. Masur 3 , S. Kottilil 1 and ASCEND Investigators. 1 Institute of Human Virology at the University of Maryland; 2 University of Maryland, Baltimore; 3 National Institutes of Health, Bethesda, United States E-mail: skattakuzhy@ihv.umaryland.edu Background and Aims: Direct acting antiviral therapy (DAA) has revolutionized the treatment of hepatitis C (HCV), however, limited evidence exists around implementation of this care. While national consensus guidelines suggest monthly visits and lab testing, it is unclear what minimum standards are necessary, and if these factors influence sustained virologic response (SVR). We investigated the predictive ability of adherence to treatment visits (ViAd) versus adherence to prescriptions (PrAd) SVR among patients treated with DAA therapy in a task-shifting model of non-specialist HCV providers. Methods: Chronic HCV-infected patients received treatment with ledipasvir/sofosbuvir under the phase IV clinical trial ASCEND, with treatment duration determined by treating provider. The primary outcome was SVR. ViAd was defined as number of visits attended out of prescribed treatment duration (2, 3, or 6 months). PrAd was defined as number of bottles picked up out of prescribed treatment duration. Statistical analysis included Chi-square or Fisher’s exact test and logistic regression using SAS. Results: 600 patients treated were predominately male (69%), black (96%), genotype 1a (72%), treatment-naïve (82%) with 20% cirrhotic and 24% HIV/HCV-coinfected. Overall, 513 achieved SVR, 85.5% by intention-to-treat (IIT) and 93.6% by per-protocol (PP). Composite ViAd was 62% and decreased over duration of treatment. ViAd was lower among patients treated by specialists (56%) compared to PCPs (63%) and NPs (73%) (p < .0001). Patients who achieved SVR IIT had higher ViAd than those who did not achieve SVR (66% vs. 41%, p < .0001). In contrast, 87% of patients had 100% PrAd. There was no statistically significant difference in PrAd between provider types. 100% PrAd was significantly associated with SVR ITT compared to those with less than 100% PrAd (89% vs. 62%, P < 0.0001). Patients who achieved SVR IIT had a higher PrAd than those who did not achieve SVR (96% vs. 84%, P < 0.0001). Conclusions: In the era of safe and efficacious DAA therapy, SVR can be achieved in patients who do not attend provider visits, as long as they pick up their medication. This data supports a limited monitoring approach for the treatment of hepatitis C. SAT-199 Predictors of minimal hepatic encephalopathy in asymptomatic HCV patients before and after antiviral treatment: preliminary results from the EMERALD study S. Levy 1,2 , N. Bar 1,2 , A. Urieli 1 , O. Shibolet 1,2 , H. Katchman 1,2 . 1 Liver Unit, Gastroenterology Depatrment, Tel Aviv Sourasky Medical Center; 2 Sackler Faculty of Medicine, Tel Aviv, Israel E-mail: hkatchman@gmail.com Background and Aims: Cognitive dysfunction in hepatitis C (HCV) patients is a distinct form of minimal hepatic encephalopathy (MHE) with a multi-factorial etiology. It mayappear irrespective of fibrosis level, impairs quality of life and increases the risk for overt encephalopathy. The aim of this pilot study was to assess MHE prevalence in HCV patients before and afteranti-viral treatment and to evaluate possible predictors of MHE development. Methods: 29 consecutive patients recruited for the EMERALD study (Abbvie 3D regimen for PI failure) underwent computerized tests for MHE (critical flicker frequency (CFF), inhibitory control test (ICT), and the Stroop test (ST)) in addition to serial blood sampling and Fibroscan. Patients with a history of hepatic encephalopathy were excluded. Evaluation was performed at base line and at end of anti- viral treatment (n = 13). Results: 15/29 patients, had advanced fibrosis (10 with F4, 5 with F3) and 14/29 had F0-F2. Eight patients were diagnosed with MHE. This diagnosis was independent of fibrosis score (F4, n = 4, F0–2, n = 4 p = 0.2185). Univariate regression analysis showed CFF results to correlate with HCV viral load (VL) ( p = 0.0021) INR (p = 0.0290) and hyperten- sion (HTN) (p = 0.0263). After multivariate analysis only VL and HTN remained significant (p = 0.0137, and p = 0.0118 respectively). ICT results correlated with VL (p = 0.0006), and years of education (p = 0.0144), while only VL remained significant in multivariate analysis (p = 0.0120). Area under receiver operating curve of VL as a predictor of MHE, diagnosed by CFF and ICT, was 0.86±0.07 [95% CI 0.717– 0.997]. High VL threshold was set above 1,100,000IU/mL, based on area under the curve and was a predictor of MHE with sensitivity 100% and specificity 63.5%. Thirteen patients (none of which had MHE diagnosed at baseline) underwent repeated evaluation after anti-viral treatment. No significant change in testing was noticed from baseline scores. Conclusions: In this pilot study we demonstrated high prevalence of MHE in HCV patients across all fibrosis levels, with high VL being the best predictor of pathologic CFF and ICT tests results. Our results suggest that MHE is underdiagnosed and that neuro-cognitive evaluation should be performed in HCV patients, especially with high VL. Further results are expected upon conclusion of recruitment. SAT-200 Hepatocellular carcinoma in patients with chronic hepatitis C and cirrhosis in Denmark S. Hallager 1 , S. Ladelund 2 , M.S. Kjaer 3,4 , L.G. Madsen 5 , E. Belard 6 , A.L. Laursen 7 , J. Gerstoft 8 , B.T. Roege 9 , K.E. Groenbael 10 , H.B. Krarup 11 , P.B. Christensen 12,13 , N. Weis 1,4 . 1 Infectious Diseases; 2 Clinical Research Department, Copenhagen University Hospital, Hvidovre; 3 Hepatology and Gastroenterology, Copenhagen Univeristy Hospital, Rigshospitalet; 4 Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen; 5 Hepatology and POSTER PRESENTATIONS S706 Journal of Hepatology 2017 vol. 66 | S543–S750