7%) tested positive for HDV antibody and/or antigen. The number of patients positive and the number of tests conducted increased over time, more than doubling between 2004 and 2009. Of those patients who tested antibody positive, less than half (44 patients, 40.0%) were subsequently evaluated by qualitative HDV PCR, and the majority of those who were (29 patients, 70.5%) tested HDV RNA positive. Surveillance data showed reasonable concordance
with laboratory diagnoses, with 88 notifications for new diagnoses of HDV reported to the Victorian Department of Health as required by public health regulations over this period (representing 80% of patients with positive test results). An increasing proportion of notifications during the time period were from Australians born overseas, particularly XL184 molecular weight in Asia and Africa, while there was a concurrent decrease in the
number reporting injecting drug use as a risk factor, from 47.5% of notifications in 2000-2004 to 23.4% during 2005-2009 (p=0.02). Conclusion: The proportion positive observed (4.7%) corresponds with global estimates of 5% HDV prevalence in people living with chronic hepatitis B, while the trend of risk factors shifting from injecting drug use towards migrants born in endemic regions reflects the pattern seen recently in a number of other countries. Increased testing for HDV in Victoria over the last decade has Lorlatinib resulted in an escalating number of HDV diagnoses and highlights the potential for undiagnosed HDV infection in those living with chronic hepatitis B; however gaps still remain in the appropriate follow-up of patients known to be infected, in order to inform effective clinical management. Fenbendazole Disclosures: The following people have nothing to disclose:
Jennifer H. MacLachlan, Benjamin C. Cowie Background and Aims: Selection of amino acid (AA) changes in hepatitis B virus (HBV) surface (S) proteins may be associated with immune response or antiviral treatment. Frequencies of AA changes (FreqAA) in S proteins during treatment with nucleoside analogs (Nucs) were assessed by ultra-deep pyrosequencing (UDPS). Methods: FreqAA in S gene codons, s92-s200, in 2 serum samples from 20 patients with chronic HBV and lamivu-dine resistance (LMVr) were analyzed by UDPS (GS-FLX/Junior, Roche). Frequency of non-polymorphic AA changes and variations in mean FreqAA>1% between baseline (BA) and LMVr were considered. Results: 595 371 sequences analyzed. Overall, a FreqAA increase was observed in 11 codons, five overlapped with LMV resistance positions and related to immune escape (figure). Decreased FreqAA was observed in sQ101 and sW1 82, mainly due to decreased sW1 82stop (3.12% to 0.38%), which overlaps with rtV1 91I associated with LMVr (figure). In “a” determinant, 45% of patients showed changes at BA and 40% at LMVr, mainly between sG1 30 and sP1 35 (no cases of sG145R).