CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

877 Hospitalizations Among Uninfected Children Exposed or Unexposed to HIV – A Nationwide Cohort Study Ellen M. Larsen 1 ; Marie Helleberg 2 ; Sannie Nordly 3 ; NinaWeis 3 ;Vibeke Rosenfeldt 3 ; Merete Storgaard 4 ; Gitte Pedersen 5 ; Isik S. Johansen 6 ; Suzanne Lunding 1 ;Terese L. Katzenstein 2 1 Nordsjællands Hospital, Hillerød, Denmark; 2 Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 3 Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark; 4 Aarhus University Hospital, Skejby, Aarhus, Denmark; 5 Aalborg University Hospital, Aalborg, Denmark; 6 Odense University Hospital, Odense, Denmark Background: Studies from resource-limited settings have shown immunological perturbations and increased risk of infectious diseases among HIV-exposed, uninfected children (HEU). Few studies from developed countries have examined morbidity in HEU. We aimed to examine risk of hospital admission among Danish HEU aged 0-4 years, compared to a matched control group of children not exposed to HIV. Methods: In a nationwide register-based study we included all HEU born in Denmark, 2000-2010. HEU were individually matched by year of birth, quarter of birth, maternal age and ethnicity to five controls born by HIV uninfected mothers. Outcomes were risk of hospital admission (any or due to an infectious disease, non-malignant hematologic disease, or symptoms with no specific diagnosis). Incidence rate ratios were estimated using Poisson regression. Person-years at risk (PY) were calculated from 1 week after birth until the first of emigration, death, fourth birthday, first admission or end of follow-up (December 31 th , 2010). Smoking during pregnancy, maternal education and number of children in household were included as covariates. Results: In total, 260 HEU and 1300 matched controls were included. HIV-infected mothers were more likely to smoke during pregnancy (15% vs. 8%) and their infants had a lower gestational age (mean: 267 days (95% CI 264-269) vs. 278 days (95% CI 276-279)), were more likely to be delivered by Caesarean Section (68% vs. 22%) and had a lower birth weight (mean 3058g (95% CI 2974-3142) vs. 3410g (95% CI 3375-3445)). A total of 231 HEU and 893 controls had at least one admission to hospital during the study period. HEU had a three-fold increased risk of overall admissions (IRR 3.2 (95% CI: 2.8-3.7)). There was no difference in risk of admission due to infectious diseases (IRR 1.0 (95% CI 0.79-1.37)), but an increased risk of admission due to non-malignant hematologic disease (IRR 3.2 (95% CI 1.5-7.0)). The excess risk/100 PY of admission was 76.7 (95% CI 62.1-93.3) and was primarily caused by an increased risk of admission with no specific diagnosis (excess IR 58.1 (95% CI 47.9-68.3), IRR 4.5 (95% CI 3.9-5.3)) (Figure 1).

Poster Abstracts

Conclusions: HEU had an increased risk of admission overall and of admission due to non-malignant hematologic disease. There was no increase in risk of admission due to infectious diseases. The excess risk of admission was mainly due to symptoms without specific diagnosis and may be caused by social problems rather than somatic disease related to HIV and ART-exposure. 878 Reassuring Birth Outcomes DataWith Atripla Used for PMTCT in Botswana Rebecca Zash 1 ; JenniferY. Chen 2 ; Sajini Souda 3 ; Scott Dryden-Peterson 4 ; Shahin Lockman 4 ; Mompati Mmalane 3 ; Joseph Makhema 3 ; Max Essex 5 ; Roger Shapiro 1 1 Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, US; 2 Massachusetts General Hospital, Harvard Medical School, Boston, MA, US; 3 Botswana Harvard AIDS Institute, Gaborone, Botswana; 4 Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US; 5 Harvard School of Public Health, Boston, MA, US Background: Prior to introduction of tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV, Atripla), 3-drug antiretroviral treatment (ART) was associated with increased adverse birth outcomes compared with zidovudine (ZDV) used for prevention of mother-to-child HIV transmission (PMTCT). We evaluated adverse birth outcomes among pregnant women initiating Atripla vs. other ART and ZDV.

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CROI 2015