Burton – Grant/Research Support: Vertex pharaceuticals, Abbvie pharmaceuticals, Gilead pharmaceuticals Jacqueline G. O’Leary- Consulting: Vertex, Gilead Gregory T. Everson – Advisory Committees or Review Panels: Roche/Genentech, Merck, HepC Connection, Roche/Genentech, Merck, HepC Connection; Board Membership: HepQuant LLC, PSC Partners, HepQuant LLC, PSC Partners; Consulting: Roche/Genentech, BMS, Gilead, Roche/Genentech, Bristol-Myers Squibb, Abbott; Grant/Research Support: Roche/Genentech, Pharmassett, Vertex, GSK, Schering-Plough, see more Bristol-Myers Squibb,

Tibotec, GlobeImmune, Pfizer, Abbott, Conatus, Zymogenetics, PSC Partners, Roche/Genentech, Pharmassett, Vertex, GSK, Schering-Plough, Tibotec, GlobeImmune, Pfizer, Gilead, Conatus, Zymogenetics, PSC Partners, Abbott; Management Position: HepQuant LLC,

Trametinib purchase HepQuant LLC; Patent Held/Filed: Univ of Colorado, Univ of Colorado Robert S. Brown – Consulting: Salix, Janssen, Vertex; Grant/Research Support: Gilead, Merck, Vertex, AbbVie, Salix, Janssen, BI; Speaking and Teaching: Genentech, Gilead, Merck James Trotter – Speaking and Teaching: Salix, Novartis Norah Terrault – Advisory Committees or Review Panels: Eisai, Biotest; Consulting: BMS; Grant/Research Support: Eisai, Biotest, Vertex, Gilead, AbbVie, Novartis The following people have nothing to disclose: Jennifer L. Dodge, Varun Saxena, Elizabeth C. Verna, Neehar D. Parikh Background/Aim Serum gamma-glutamyl transferase (r-GT) levels were associated with liver disease severity. We aimed to explore the association of r-GT and HCV-related HCC development in patients with a sustained virological response (SVR). Methods Clinical parameters including r-GT levels

of 856 patients who achieved an SVR were evaluated from 2002 to 2010. Results Thirty-three patients (3.9 %) developed HCC within a median follow-up period of 44.2 months (range 9-91 months). Cox regression analysis revealed that the strongest factor predictive of HCC occurrence was liver cirrhosis (hazard ratio [HR] 5.49, 95% confidence intervals [CI.] 1.74-8.37, P<0.001), followed by age (HR 1.06, 95% CI. 1.02-1.06, P=0.005) Amoxicillin and r-GT levels (HR 1.008, 95% CI. 1.004-1.013, P=0.001). The r-GT levels did not differ between cirrhotic patients with or without HCC (77.7+64.7 u/L vs. 75.0+67.8 U/L, P=0.93), and the incidence of HCC did not differ between patients with high or low r-GT levels (log-rank test P=0.49). On the contrary, the r-GT levels were significantly higher in non-cirrhotic patients with HCC development than those without (100.3+79.2 u/L vs. 61.8+54.8 U/L, P=0.03), and the incidence of HCC was significantly higher in those with high r-GT levels as compared with those without (log-rank test P=0.004). Cox regression analysis revealed that the strongest factor associated with HCC development in non-cirrhotic patients was high r-GT levels (HR 5.28, 95% CI. 1.73-16.17, P=0.004), followed by male gender (HR 4.69, 95% CI. 1.26-17.38, P=0.