753 INSULIN RESISTANCE IS INDEPENDENTLY ASSOCIATED WITH ADVANCED LIVER FIBROSIS AND HIGH BODY MASS INDEX IN HIV/HCV-COINFECTED PATIENTS

Results: Among 145 patients with serologically silent occult HCV infection 45 (31%) tested anti-HCVcore-positive at the time of the diagnostic biopsy.Anti-HCVcore was detected in 143/145 (98.6%) chronic hepatitis C patients but in none of the 140 patients with HCV-unrelated liver disease (P < 0.001).A serological follow-up was conducted in occult HCV-infected patients (every 3-6 months for at least 12 months).Among 23 anti-HCVcorepositive patients at baseline, 18 remained antibody-reactive on all occasions tested; anti-HCVcore fluctuated in 4 (from positive to negative and viceversa) and was lost in one patient.Similarly, among 31 anti-HCVcorenegative at baseline, 17 remained antibody non-reactive; however, 4 patients seroconverted to anti-HCVcore and remained so whereas anti-HCVcore became reactive in 10 patients on at least one occasion.Thus, a total of 59/145 (40.7%) patients with occult HCV infection reacted in the anti-HCVcore assay at any time-point analyzed, including 14 initially non-reactive patients.By supplemental anti-HCV immunoblot assay 16/83 (19.2%) sera reacted weakly with a single core-peptide band (indeterminate test result) of which 10/16 (62.5%) reacted in the anti-HCVcore ELISA.According to anti-HCVcore status, occult HCV-infected patients who tested anti-HCVcore-positive showed significantly greater scores of necroinflammation (P = 0.046) and percentages of HCV RNA-positive hepatocytes (P = 0.004) compared with the anti-HCVcore-negative counterparts.Conclusion: Anti-HCVcore is detectable in 40% patients with serologically silent occult HCV infection.Anti-HCVcore testing improves serodiagnosis of HCV infection in patients lacking serum anti-HCV and HCV RNA using commercial tests.This anti-HCVcore assay may be useful in tracking subclinical HCV infections.