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No abstract available. Article truncated after 150 words. Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome-related coronavirus-2 (SARS–CoV-2) infection. The United States (US) currently has more officially reported cases and deaths from COVID-19 than any other country in the world. The rural Southwestern American Indian (SAI) tribes are disproportionately affected, due to genetics, immunological naivety, social determinants of health, and high prevalence of concomitant comorbidities and co-exposures (1). On March 30, 2020, the New Mexico Governor, Michelle Lujan Grisham, informed the US President Donald Trump of the “incredible spikes” in cases of COVID-19 within the Navajo Nation in the rural Four Corners region of the American Southwest (2). The Governor warned that the disease “... could wipe out those tribal nations.” Use of COVID-19 testing as an approach to combating the pandemic is supported by an Iceland-based epidemiological study, and endorsed by the World Health Organization (3). Rural states in the US rank …

David R Walker, Timothy R Juday, Shivaji R Manthena, Yonghua Jing, Vipan Sood Health Economics and Outcomes Research, AbbVie Inc., North Chicago, IL, USA Background: Combination therapy with sofosbuvir (SOF) and simeprevir (SIM) is used to treat patients with hepatitis C virus infection. It is currently unknown whether adding ribavirin (RBV) to SOF + SIM, which raises the pill count from two up to eight pills a day, impacts adherence. The aim of this study is to examine the impact of pill count on real-world adherence rates in patients treated with SOF + SIM with and without RBV. Methods: This retrospective study assessed composite adherence to SOF and SIM over 12 weeks of treatment for two cohorts of hepatitis C patients: one initiating SOF + SIM therapy, and the other initiating SOF + SIM + RBV therapy. Analyses were conducted using MarketScan® and Optum US commercial pharmacy claims and enrollment data. Adherence was adjusted by treatment regimen, age, sex, co-pay, presence/absence of cirrhosis, treatment history, and Charlson Comorbidity Index. Results: There was a significant difference in composite unadjusted and adjusted adherence rates for SOF and SIM for the SOF + SIM vs SOF + SIM + RBV cohorts based on MarketScan data (unadjusted, 92.6% and 89.7%, respectively; P=0.0423; adjusted, 92.2% and 88.7%, respectively; P=0.0176), but not based on Optum data (unadjusted, 94.8% and 95.6%, respectively; P=0.5618; adjusted, 94.8% and 95.1%, respectively; P=0.8589). In the MarketScan and Optum databases, there were no statistical differences in unadjusted and adjusted adherence rates for SOF. Unadjusted and adjusted adherence rates for SIM were mixed, as they were for composite adherence. Conclusion: The impact of the addition of RBV to SOF + SIM therapy was mixed. The impact of RBV on SOF adherence was not significant in either database. Keywords: adherence, hepatitis C, direct acting antiviral, sofosbuvir, simeprevir, ribavirin

Rupal Morjaria,1,2 Vaneeta Sood,1 Kaveh Manavi,1 Alastair K Denniston,1,3 Helen Palmer1 1Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom; 2Nuffield Department of Ophthalmology, Oxford University Hospitals National Health Service Trust, Oxford, United Kingdom; 3Centre for Translational Inflammation Research, University of Birmingham, Birmingham, United Kingdom Background: Before highly active antiretroviral therapy, cytomegalovirus (CMV) retinitis was a major threat to vision in individuals with HIV. We investigate whether ophthalmic screening of asymptomatic HIV patients still has value in the highly active antiretroviral therapy era and consider CD4 thresholds in line with the world literature and UK experience.Methods: A retrospective chart review was conducted of all patients seen by the HIV ­Ophthalmic Service of a UK university hospital both before (2007–2008) and after (2011–2012) introduction of a threshold of CD4 lower than 100 cells/mm3. Data collected included CMV and HIV RNA load, CD4 cell counts and CD4 percentage, CMV-immunoglobulin G status, ocular symptoms, and evidence of HIV-related ocular disease. Results: In total, 54 patients were referred to the HIV ophthalmic service. Three patients failed to attend, resulting in complete data for 51 patients (n=24 for 2007–2008; n=27 for 2011–2012). Seven patients had ophthalmic manifestations of their HIV; these cases had lower CD4 counts than those with normal examinations (median [interquartile range], 9 [7–80] versus 175 [44–394]; P=0.0039; Mann–Whitney test). Six cases had HIV retinopathy without sight loss; one case had sight-threatening CMV retinitis associated with a CD4 count of 6 cells/mm3. Conclusion: Before 2008, our practice was to screen all asymptomatic patients with CD4 counts lower than 200 cells/mm3. Screening asymptomatic patients with CD4 counts below 100 cells/mm3 was not associated with any missed or late-presenting cases of CMV retinitis in our HIV population. Keywords: cytomegalovirus retinitis, HIV, HAART

LeeAnn Braun,1 Vipan Sood,2 Susan Hogue,1 Bonnie Lieberman,2 Catherine Copley-Merriman11RTI Health Solutions, Ann Arbor, MI, 2Mitsubishi Tanabe Pharma America, Inc, Warren, NJ, USAAbstract: Chronic kidney disease (CKD) is a complex debilitating condition affecting more than 70 million people worldwide. With the increased prevalence in risk factors such as diabetes, hypertension, and cardiovascular disease in an aging population, CKD prevalence is also expected to increase. Increased awareness and understanding of the overall CKD burden by health care teams (patients, clinicians, and payers) is warranted so that overall care and treatment management may improve. This review of the burden of CKD summarizes available evidence of the clinical, humanistic, and economic burden of CKD and the current unmet need for new treatments and serves as a resource on the overall burden. Across countries, CKD prevalence varies considerably and is dependent upon patient characteristics. The prevalence of risk factors including diabetes, hypertension, cardiovascular disease, and congestive heart failure is noticeably higher in patients with lower estimated glomerular filtration rates (eGFRs) and results in highly complex CKD patient populations. As CKD severity worsens, there is a subsequent decline in patient health-related quality of life and an increased use of health care resources as well as burgeoning costs. With current treatment, nearly half of patients progress to unfavorable renal and cardiovascular outcomes. Although curative treatment that will arrest kidney deterioration is desired, innovative agents under investigation for CKD to slow kidney deterioration, such as atrasentan, bardoxolone methyl, and spherical carbon adsorbent, may offer patients healthier and more productive lives.Keywords: quality of life, economics, disease classification, treatment, eGFR

Background: Blackgram despite of being a highly nutritious and short duration legume crop, it is not cultivated on large scales due to many constraints. Considering this, the research was aimed to develop blackgram genotypes with wider adaptability, genetic variability and high yielding potential by studying nature and magnitude of association among yield and related traits for effective production. Methods: The present investigation was carried out at Experimental Farm of the Department of Genetics and Plant Breeding, College of Agriculture, CSK HPKV, Palampur (H.P.) to assess the character association and direct and indirect effects among yield and related traits in 14 crosses and ten parents for 11 quantitative characters during Kharif 2018 and 2019 in randomized complete block design with three replications. Result: Correlation studies highlighted that seed yield per plant had significant and positive association with pods per plant, biological yield per plant, pod length, plant height and 100 seed-weight at genotypic and phenotypic levels in both generations. Study of path analysis revealed that biological yield per plant and pods per plant exhibited maximum positive direct and indirect effects to the total association between yield and other component traits in both the generations. These traits could be suggested as best selection indices on priority basis which would be commendable to improve the performance of genotypes during breeding programme. [ABSTRACT FROM AUTHOR]