CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Results: Trunk fat mass/ limb fat mass ratio in HIV+T2D+ was elevated compared to HIV-T2D+ and HIV-T2D, but not when compared to HIV+T2D- (Fig. 1A). HIV+T2D+ tended to have higher trunk fat mass (17.2 kg (13.5-20.8)) compared to HIV+T2D- (12.4 kg (8.9 – 15.9), p=0.057) and HIV-T2D- (13.0 kg (11.5-14.6), p=0.020, but not compared to HIV-T2D+ (18.6 (16.2-21.0), p=0.495). IL- 6 was elevated in HIV+T2D+ compared to HIV+T2D- and HIV-T2D- but not when compared to HIV-T2D+ (Fig. 1B). Adiponectin was decreased in HIV+T2D+ compared to HIV+T2D- and HIV-T2D- but not when compared to HIV-T2D+ (Fig. 1C). Furthermore, adiponectin was negatively correlated to trunk fat mass/ limb fat mass ratio in all four groups: HIV+T2D+ p= 0.019 r= -0.546, HIV+T2D- p=0.006, r= -0.622, HIV-T2D+ p= 0.006, r= -0.603, HIV-T2D- p<0.738, r=-0.662.

Conclusions: The combination of HIV infection and T2D had adverse effects on body composition and inflammation. Impact of T2D on inflammation seemed to be more pronounced than that of HIV infection. Body composition was altered in both HIV-infected persons and those with T2D. Our results suggest that persons with both HIV infection and T2D may be especially vulnerable to altered body composition and inflammation possibly leading to increased risk of cardiovascular disease. 804 Alcohol, Substance Use, and Smoking Associations With Lipoatrophy and Lipohypertrophy Marisela Noorhasan 1 ; Daniel R. Drozd 1 ; Aaron Blashill 2 ; Greer Burkholder 3 ; Karen Cropsey 3 ; Matthew Mimiaga 2 ; Katerina Christopoulos 4 ; Carl Grunfeld 4 ; Heidi M. Crane 1 Centers for AIDS Research Network of Integrated Clinical Systems 1 University of Washington, Seattle, WA, US; 2 Harvard Medical School, Boston, MA, US; 3 University of Alabama at Birmingham, Birmingham, AL, US; 4 University of California San Francisco, San Francisco, CA, US Background: We sought to examine the associations between alcohol and substance use with body morphology. Unlike many previous studies, we did not combine lipoatrophy and lipohypertrophy outcomes, and were able to take into account correlated behavioral factors such as substance abuse, physical activity, and smoking. Methods: Eligible patients were in CNICS at 6 sites and completed a touch-screen-based assessment as part of clinical care between 2006-2013 including body morphology (FRAM instrument), drug/alcohol use, physical activity level, and smoking. We used generalized estimating equations to assess differences in body morphology associated with alcohol, tobacco, and other substance use, controlling for age, race, sex, site, currently receiving ART, current and nadir CD4 cell count, viral load, hepatitis C virus, and physical activity level. Results: The clinical assessment was completed 21,279 times by 7931 patients. Older age, detectable viral load and high current CD4 cell counts were associated with more severe lipoatrophy in adjusted analyses while black race was associated with less severe lipoatrophy ( p values <0.001-0.008). Current cigarette smoking, marijuana use, and opiate use were all associated with more severe lipoatrophy ( p values <0.001-0.03). Compared with patients with very low physical activity levels, all other activity levels were associated with less severe lipoatrophy ( p values <0.001). Older age, male sex, and higher current CD4 count were all associated with more severe lipohypertrophy in adjusted analyses ( p values <0.001-0.04). A higher CD4 cell count nadir and current cigarette smoking were associated with less severe lipohypertrophy ( p <0.001-0.04). Prior amphetamine use, prior and current cocaine use and prior marijuana use were all associated with more severe lipohypertrophy ( p values <0.001-0.002). Compared with very low levels of physical activity, all other physical activity levels were associated with less severe lipohypertrophy ( p values<0.001). Conclusions: These results support the conclusion that lipoatrophy and lipohypertrophy are distinct. While lack of physical activity and higher CD4 counts are associated with both lipoatrophy and lipohypertrophy, associations with substance use and other clinical characteristics are different. These results may prove useful in counseling patients who wish to avoid body morphology changes and further our understanding of associations with these conditions and their possible mechanisms. 2:30 pm– 4:00 pm Complications: Liver DiseaseWithout Viral Hepatitis 805 Antiretroviral Drugs AssociatedWith Chronic ALT Elevations in Persons Without HCV and HBV Infection Helen Kovari 1 ; Caroline Sabin 2 ; Bruno Ledergerber 1 ; Lene Ryom 3 ; Antonella d’Arminio Monforte 4 ; Matthew G. Law 5 ; Stéphane DeWit 6 ; Andrew N. Phillips 2 ; Jens D. Lundgren 3 ; RainerWeber 1 on behalf of the D:A:D Study Group 1 University Hospital Zurich, Zurich, Switzerland; 2 University College London, London, United Kingdom; 3 University of Copenhagen, Copenhagen, Denmark; 4 University of Milan, Milan, Italy; 5 University of New South Wales, Sydney, Australia; 6 St Pierre University Hospital, Brussels, Belgium Background: Whilst HIV-positive persons on ART frequently have chronic liver enzyme elevation (LEE), the underlying cause is often unclear. Methods: D:A:D participants without HBV/HCV infection, with ≥ 3 alanine aminotransferase (ALT) measurements and normal baseline ALT, were followed from study entry to the earliest of chronic LEE, death, 1 st Feb 2013, or last follow-up. Chronic LEE was defined as ALT >50/>35 U/L (males/females) at ≥ 2 visits spanning at least 6 months within 2 years. ART exposure was categorized as follows: no exposure; ongoing exposure either for < or ≥ 2yrs after initiation; and discontinued < or ≥ 2yrs earlier. Poisson regression was used to analyze LEE and its’ association with ART and traditional risk factors (details see footnote in figure). THURSDAY, FEBRUARY 26, 2015 Session P-Q12 Poster Session Poster Hall

Poster Abstracts

490

CROI 2015