Transient elastography (Fibroscan) showed high accuracy for the non-invasive diagnosis of cirrhosis but its value for subclinical cirrhosis is unknown. In our Unit, between 2010 and 2013 a valid Fibroscan was obtained in 1492 consecutive patients with chronic liver disease (CLD). Unreliable Fibroscan (failure, IQR>30%, <10 valid measures, risk of false positivity) were excluded.

Patients were divided into three groups: subclinical cirrhosis (Fibroscan >13kPa and absence of thrombocytope-nia, ultrasonographic mTOR inhibitor signs of advanced liver disease/splenomegaly, esophageal varices, ascites); clinically overt (CO) cirrhosis (Fibroscan >13kPa with any of the previous signs); and non-cirrhotic CLD (Fibroscan<1 3kPa). During a mean follow-up of 18.6 months (range 6-36, 60% of cases having>18 months), we evaluated longitudinally ERK inhibitor the clinical outcome of subclinical cirrhosis as compared to CO cirrhosis and non-cirrhotic CLD groups. The outcomes were determined by cumulative incidence of new clinical events related to cirrhosis during the follow-up. Overall, the distribution of the study groups was as follows: 1 15 (7.7%) had subclinical cirrhosis, 275 (18.4%) had CO cirrhosis, 1102 (73.9%) had non-cir-rhotic CLD. Of the total 390 cases with Fibroscan >1 3kPa indicating cirrhosis, subclinical cirrhosis represented 29.5%. As compared to non-cirrhotic CLD, subclinical cirrhosis patients were older (53 vs 49 yrs, p=0.008), had

higher BMI (28 vs 25, p<0.001), higher HCV prevalence (57 vs 42%, p=0.02), and higher values of fibrosis biomarkers including APRI (1.2 vs 0.6, p<0.05) and Fib-4 (2.1 vs 1.3, p<0.0001). During the longitudinal follow-up, the subclinical cirrhosis group had a higher incidence 上海皓元 of cirrhosis-related events as compared to non-cirrhotic CLD group, including HCC (Table). Conclusions: Subclinical cirrhosis diagnosed by Fibroscan represents

29% of the patients with cirrhosis and 7% of all CLD patients seen in a Liver Unit. Patients with subclinical cirrhosis may develop severe complications, including HCC. Screening of CLD patients with Fibroscan may help early identification of subclinical cirrhosis and establishing a surveillance program for HCC and varices.   Thrombocytopenia Ultrasonographic signs Esophageal varices Ascites HCC Cumulative incidence *p<0.01 between subclinical cirrhosis and clinically overt cirrhosis; **p<0.0001 between subclinical cirrhosis and non-cirrhotic CLD. Disclosures: Philip Wong – Advisory Committees or Review Panels: gilead, gilead, gilead, gilead; Grant/Research Support: merck, roche, merck, roche, merck, roche, merck, roche The following people have nothing to disclose: Tianyan Chen, Remy E. Wong, Rasha Alshaalan, Marc Deschenes, Peter Ghali, Giada Sebastiani Liver fibrosis is the progressive accumulation of connective tissue that affects the normal function of the liver and will eventually lead to liver cirrhosis.