CROI 2015 Program and Abstracts

Abstract Listing

Oral Abstracts

(Figure). At lower probabilities of observed outcome, the model tended to overestimate the probability of poor outcome, while at higher ranges of observed outcome, it slightly underestimated outcomes.

Figure. Calibration of risk prediction model. For each successive decile of predicted probability of progression/death, the mean predicted and observed probabilities for the patients in the decile group are shown. Conclusions: A prognostic model, consisting of inexpensive measurements, can help to predict which patients in Africa with KS—who present with no functionally disabling complications—will fare poorly when treated with ART alone. The presence of number of KS-containing anatomic sites and hemoglobin in the model suggests the importance of quantitative KS burden in prognosis. The model may help clinicians better advise patients about prognosis and, importantly, inform chemotherapy decisions. 89 One-Year Follow-up of HIV+Women ScreenedWith VIA, Cytology and HPV in South Africa Cynthia Firnhaber 1 ; Bridgette Goeieman 1 ; Lu Mao 2 ; Mark Faesen 3 ; Simon Levin 3 ; SophieWilliams 3 ; Avril Swarts 1 ; PamMichelow 1 ;Tanvier Omar 1 ; Jennifer Smith 2 1 University of Witswatersrand, Johannesburg, South Africa; 2 University of North Carolina, Raleigh, NC, US; 3 Right to Care, Johannesburg, South Africa Background: Cervical cancer is the most common cause of cancer deaths in women in Sub-Saharan Africa. This is due to the burden of the HIV epidemic as well as poor access to screening. Visual inspection with acetic acid (VIA) has been proposed as a screening method for the region, however, there are limited follow-up data for HIV-infected women who have been screened using VIA. This information is needed to inform screening guidelines. We present one year follow up data on a prospective cervical cancer screening study performed in Johannesburg, South Africa. Methods: HIV-infected women fromwere rescreened one year later with standard Pap smear and/or colposcopy, VIA and digene HC HPV test, if they had negative or low grade cervical intraepithelial neoplasia (CIN) results at the baseline visit. Associations of progression to higher cervical dyplasia on histology with baseline age, CD4 count, VIA and human papillomavirus (HPV) status were analysed using logistic regression. Results: A total of 677 of the 1202 women enrolled at baseline were eligible for follow-up and returned at one year. 629 women qualified for colposcopic biopsy and were included in analyses. Median age of the women was 37 years (IQR 32,43). At follow-up, median CD4 count was 387 cells/mm 3 (IQR 250,571) and 93% of the participants were on antiretroviral therapy. Women with CIN 1 and HPV positive results were likely to progress to CIN-2+ [OR 3.63 (1.45-9.1) versus HPV negative]. Women with positive VIA were likely to progress from negative to a CIN 1 [OR 13.35 (1.73-102.8)] and from CIN 1 to CIN 2+ [OR 1.85 (0.92-3.72)], see Table. At one year, 60% (127/211) of the women with either negative cytology and/or histology progressed to CIN 1+ and 10% (40/418) of the CIN 1 cases progressed to CIN 2+. Of 437 women with negative baseline VIA, 18 (4%) progressed to CIN 2+ in one year; 3/192 with negative pathology and 15/245 with CIN 1. Overall, women with a positive VIA or HPV at baseline were likely to progress at one year [OR 3.09 (1.67-5.72) and OR 1.68 (1.02-2.77), respectively].

Oral Abstracts

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CROI 2015