CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Results: Among 173 HIV infected ART naïve children, median age was 2.3 years (IQR 1.3, 4.5). Most (72%) of their mothers had been tested for HIV during pregnancy with higher testing rates in lower age groups [age <18 months (86%), 1.5-5 years (73%), 5-8 years (44%), and 8-12 years (56%) (p=0.01)]. Seventy one (57%) of mothers tested HIV negative during pregnancy. Of the 51(41%) of mothers who tested positive, 34 (67%) of mothers and 18 (35%) of infants received ARV’s for PMTCT. Almost all infants (97%) had breastfed. More than a third of all the children 67(39%) had previous hospitalizations, with 25 (38%) having multiple hospitalizations. Of 85 children previously tested for HIV, nearly half 39(49%) had tested HIV positive but had not initiated ART.

Conclusions: Current systems often fail to detect HIV among women who acquire the infection after a negative test at PMTCT. Pediatric HIV testing and linkage may not occur even after hospitalization. Repeat maternal HIV testing, routine PITC and prompt linkage to care is necessary to prevent late identification of HIV-infected children.

TUESDAY, FEBRUARY 24, 2015 Session P-U2 Poster Session

Poster Hall

2:30 pm– 4:00 pm Early ART and HIV Persistence 912 Early Infant Antiretroviral Therapy Reduces Transcriptionally Active HIV Persistence Gert U. van Zyl 1 ; Margaret A. Bedison 2 ; Anita Janse van Rensburg 3 ; Barbara Laughton 3 ; Mark F. Cotton 3 ; JohnW. Mellors 2 1 Stellenbosch University and National Health Laboratory Service, Parow, South Africa; 2 University of Pittsburgh, Pittsburgh, PA, US; 3 Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa Background: Early combination antiretroviral therapy (cART) has been shown to reduce the number of HIV-1 DNA containing cells in blood but it is not known how the timing of cART initiation impacts transcriptionally active proviruses or persistent low level plasma viremia. We therefore investigated multiple measures of HIV-1 persistence in children from the “Children with HIV Early Antiretroviral Therapy” (CHER) cohort Methods: Twenty children were studied from the post CHER cohort, 7-8 years old and on cART for 79-96 months, who received continuous cART either from before (n=12) or after (n=8) 2 months of age and who had HIV-1 RNA suppressed (<400 copies/ml). Longitudinal PBMC and plasma samples were assayed by subtype C-specific quantitative PCR for cell associated HIV-1 DNA (CAD), cell associated HIV-1 RNA (CAR) and plasma HIV-1 RNA with primers and probes targeting a highly-conserved region of integrase . Results: The median (inter quartile-range (IQR)) CAD and CAR levels were significantly lower (p<0.01) in children who initiated cART at <2 months of age (early) compared to >2 months of age (later): 48 (IQR: 10-94) versus 216 (135-473) HIV-1 DNA copies/million PBMC; and 5 (4-37) versus 436 (48-994) HIV-1 RNA copies/million PMBCs, respectively. One of 12 early treated children had undetectable CAD, versus none of 8 late-treated and 7 out of 12 early treated children had undetectable CAR versus 1 out of 8 (p=0.07). Median plasma HIV-1 RNA was lower in children starting cART at < 2 months (0.5 copies/ml; IQR: 0.5-1.1) compared to children starting cART at ≥ 2 months (1.2 copies/ml; IQR: 0.5-2.8; p=0.16). Similarly, 9 of 12 early-treated had undetectable plasma HIV-1 RNA (<0.6 copies/ml) compared to 3 of 8 later treated (p=0.17). Comparisons of CAD, CAR and HIV plasma RNA in early- vs later-treated children are shown in Figure 1.

Poster Abstracts

547

CROI 2015