Disclosures: Lai Wei – Board Membership: Gilead; Grant/Research Support: BMS, Roche, Novartis; Speaking and Teaching: Gilead The following people have nothing to disclose: Jingmin Zhao, Liyuan Wu, Shuhong Liu, Yulai Zhao, Wenshu Li, Jin Li, Jiyun Lv Background: How the find more liver responds to chronic viral infection

reflects intrinsic differences in the host immune response. In chronic HCV infection, patients who respond well to interferon (IFN) have low/absent IFN-stimulated gene (ISG) expression in hepatocytes (HC) but significant ISG expression in Kupffer cells (KC). Non-responders (NR) show the opposite pattern. The outcome of triple therapy with protease inhibitors (PI) is largely dependent on the intrinsic IFN response, suggesting that differences in HC/KC ISG expression may still be associated with treatment response with current regimens. Aim: To determine the association between cell-type specific ISG staining and treatment outcome with PI-based triple therapy. Methods: Consecutive patients treated with boceprevir or telaprevir with pegIFN and RBV who underwent pretreatment liver biopsy were included. Biopsy tissue was stained for the ISG myxovirus A (MxA) and

read by 2 pathologists blinded to treatment outcome. Staining was scored from 0 to 3 in KC and HC, as described. IL28B genotyping was performed in a subset of patients. Results: Of 63 patients included, 65% were male, mean age was 52 years, 73% were Caucasian and 45% had F3/4 fibrosis. Of 32 with IL28B genotyping, see more 31% were CC, 44% CT and 25% TT. Telaprevir was used in 71 % and boceprevir in 29% of patients. Of those with final treatment outcome, 23 (64%) achieved SVR, 3 (8%)

relapsed and 10 (28%) were NRs. MxA staining was higher in KC and lower in HC in patients who achieved SVR (KC: 2.2 SVR vs 1.1 non-SVR p=0.002, HC: 2.3 SVR vs 3.0 non-SVR, p=0.026). Relapsers had similar staining patterns as those with SVR. MxA staining correlated with IL28B genotype with stronger KC staining in CC than non-CC patients (2.45 vs 1.2 p=0.001) and lower HC staining in CC patients (2.2 vs 2.9 p=0.003). All 19 patients with strong (>2+) KC staining and weak (<1) HC staining achieved aminophylline end of treatment responses, with 17 (89%) going on to SVR. Similarly, all NRs showed weak or absent KC staining and strong HC staining (p<0.0001). By logistic regression, mean KC staining was significantly associated with SVR (OR 4.5 1.2–17) after controlling for baseline HCV RNA, fibrosis and choice of PI. KC and HC staining were not predictive of early on-treatment responses. Conclusions: The relative expression of ISGs in hepatocytes and macrophages is strongly associated with treatment responses to PI-based triple therapy. The persistent strength of this association highlights the importance of the hepatocyte-macrophage interaction to the hepatic innate immune response. Disclosures: Jordan J.