2% 15/28 53.6% 61/79 77.2% 13/15 86.7% 95% CI (47.2–73.6) (35.8–70.5) (66.8–85.1) (62.1–96.3) Year 2 36/49 73% 17/28 60.7% 66/79 83.5% 13/15 86.7% 95% CI (59.7–83.8) (42.4–76.4) (59.7–83.8) (62.1–96.3) Year 3 39/49 79.6% 22/28 78.6% 77/79 97.5%

15/15 100% 95% CI (66.4–88.5) (60.1–89.8) (91.2–99.3) (79.6–100) Year 4 42/49 85.7% 23/28 82.1% 78/79 98.7% 15/15 100% 95% CI (73.3–92.9) (64–92) (93.1–99.8) (79.6–100) Conclusion: This study demonstrates that treatment experienced patients can achieve high rates of viral suppression similar to those that are treatment naïve. M ROBERTSON,1 Antiinfection Compound Library CLW SUEN,1 K JAYASINGHE,1 A CHONG3 AND W SIEVERT1,2 1Department of Gastroenterology and Hepatology, Monash Health, 2Centre for Inflammatory Disease, Monash University, and 3Pharmacy Department, Monash Health, Melbourne, Australia Background: Reactivation of hepatitis B virus (HBV) replication in patients receiving rituximab (RTX)

is well described. International guidelines, including the American Association for the Study of Liver Diseases (AASLD) and American Society of Clinical Oncology (ASCO), endorse HBV screening (HBV surface antigen (HBsAg) and core antibody (anti-HBc) prior to RTX therapy and recommend prophylactic antiviral therapy in patients with detectable HBsAg. Discordant recommendations exist for patients with serological evidence of prior infection (HBsAg negative and anti-HBc positive). selleck compound Aim: To investigate adherence to HBV screening guidelines prior to commencing

RTX and to investigate clinical outcomes in RTX-treated patients with evidence of current or past HBV infection. Methods: All patients receiving RTX at Monash Health, a tertiary referral centre for 1.2 million people, over a 60-month period from 2008 to 2012 were identified via pharmacy dispensing records. Medical records were reviewed to determine the timing and type of HBV screening. HBV flares (defined as ALT >5 MCE X ULN) and reactivation (defined by detectable viraemia) were identified and correlated with clinical outcomes. Results: 586 patients received RTX for haematological (75%), rheumatological (10.4%), renal (12.4%) or other (2.2%) indications. Mean patient age was 60 years (range 4–96) and 58% were male. 361(62%) patients received pre-RTX HBV screening which was more likely to occur in patients with renal (92%) compared with haematological (61%, p < 0.001) or rheumatological (28%, p < 0.001) indications. Of screened patients, 344 (95.6%) were tested for HBsAg with 4 (1.2%) detected, 133 (36.8%) for anti-HBc with 25 (18.8%) detected and 91 (25.3%) for anti-HBs with 37 (40.7%) detected. Only 119 (33% of those tested and 20.3% of total cohort) had recommended screening with HBsAg and anti-HBc. All HBsAg positive patients received prophylactic antiviral treatment. 15 (60%) patients with only anti-HBc detected (all receiving rituximab for a haematological condition) received antiviral therapy.